Monday, May 12th, 2008 09:54 am
Why yes, I am a very pale woman who avoids sunlight because I burn so darn fast. I even work indoors all day. Why yes, I throw up when I eat fish and seafood. Why yes, I am mildly lactose-intolerant and do not drink a lot of milk.

I am now on 5000 IU of vitamin D per day, and after a couple of weeks, I'll want to maintain at 3000 IU/day.

Guess what vitamin D deficiency can cause. Guess. Remember all the agony I was going through with dietary sodium? Vitamin D deficiency can cause high blood pressure! Heh.

So now that's five little pills for D and one annoying injection of B12. There's hope that I can stop the B12 in a month or so... unless my feet spontaneously heal, in which case, bring on the needles.
Monday, May 12th, 2008 05:19 pm (UTC)
For B12 I highly recommend fresh beer. In particular, the yeast of unfiltered beer is a great source of B12. So get home-brewing and as you drink your fill you'll get ingesting a great source of B12!
Monday, May 12th, 2008 05:28 pm (UTC)
Got a quantity on that? I need to check the labels when I get home, but I think my injection is 10,000 units IU of B12. How many beers are we talking here?
Monday, May 12th, 2008 05:39 pm (UTC)
I'm not sure how much is 10000 units. RDA is about 1 tablespoon of yeast, which is probably about 2-3 beers, so probably too much to have daily.
Monday, May 12th, 2008 06:13 pm (UTC)
Ah, right. If my IU/microgram conversion is correct (1:0.025 for B12), and if I'm remembering my dosage right, I'm currently taking one hundred times that amount.
Monday, May 12th, 2008 06:19 pm (UTC)
That would be a lot of beer.

Got the taste for vegemite? ;)
Monday, May 12th, 2008 05:42 pm (UTC)
Ok, I give up. is the vitamin D and the tests and the vitamin B12 related to your NYC visit or some other new medical issue?
Monday, May 12th, 2008 06:09 pm (UTC)
D is by my local doc who was wondering why I have high blood pressure. (Well, besides the fact that I am now a couch potato.) B12 is by a different local doc who thinks B might somehow help my feet.

Switching docs always means a big pile of this kind of thing. *sigh*. At least the guy with the D seems to be spot on. We'll see about the B.

I'm also working my way through a handful of tests the NYC doc wanted me to get done locally. Some days I'm annoyed that I have this job thing, because it keeps interfering with stuff I need to get done! :)
Monday, May 12th, 2008 06:29 pm (UTC)
Ah, thanks.

Vit. B seems to be the cure for everything these days.
Monday, May 12th, 2008 06:23 pm (UTC)
Did anyone check out your bone calcium (it's a dexascan test) - I know they say calcium works better with vitamin d being taken and I wonder if the reverse is true?

Monday, May 12th, 2008 06:30 pm (UTC)
There are two bone-related tests the NYC doctor ordered, but I don't know whether either of them shows calcium levels. Would a bone density scan do that? That's one of them.
Tuesday, May 13th, 2008 12:24 am (UTC)
I think that's the test I'm thinking of - it's for osteporosis.
Tuesday, May 13th, 2008 12:47 am (UTC)
I admit that when I first saw the order for that test, I thought, "Dr. J may be looking for early menopause in a 40-year-old woman showing these symptoms -- but I'm a 40-year-old woman who has had these symptoms since she was 35." On the other hand, who knows? He could be right. So. I go be good patient. I go get scan.
Monday, May 12th, 2008 06:25 pm (UTC)
Vitamin D deficiency can cause high BP? Interesting... didn't know that. I've been on 2000 whatevers of D for the past few months, because I don't drink milk and don't get a lot of sun and am on well water (apparently town water has D added to it, who knew?).

I'm actually hoping that that, plus my iron, might make my bp more stable. *fingers crossed* I'd love to get off at least one of the bp meds I'm on. Thanks for the info!!
Monday, May 12th, 2008 06:42 pm (UTC)
It's only now being recognized, but yeah. Hypertension is mentioned briefly in the NIH's Vitamin D fact sheet, though sadly I don't have access to the source article they reference. I don't have access to the one this Reuters article is based on, either, nor the one Wikipedia refers to about peripheral artery disease.

Of course, whether supplementation helps is also up in the air. Some people are deficient because of various metabolic reasons, not low intake or low sunlight. Me, I don't eat any fish or seafood (ding!) and I avoid sunlight (ding!) so I suspect my problem is simply that I'm not getting much of it.
Monday, May 12th, 2008 06:27 pm (UTC)
That vitamin D is seriously good stuff. I'm black Irish, so I get my doses the old-fashioned way--but yeah, it's good for what ails you.
Monday, May 12th, 2008 06:54 pm (UTC)
Enough B is really good too, and I'm starting to learn more about some of the rest. It's amazing, but health really IS related to nutrition. Who'd'a thunk it? :-)
Monday, May 12th, 2008 06:42 pm (UTC)
If I remember correctly, according to Alton Brown, you should be able to eat cheese without aggravating your lactose intolerance.

Also - I highly recommend a reduced carb, zero refined carb diet to get your blood pressure down. Sam's BP dropped by a good 15 points before he started exercising again.
Monday, May 12th, 2008 06:51 pm (UTC)
Yes, most cheeses I like don't give me trouble.

According to my doc, the effect of a low carb diet on blood pressure works particularly well for people with metabolic syndrome, of which I have only two signs rather than the three my doctor requires for diagnosis. (My waist to hip ratio is laughably small, my HDL is fantabulous, and I have no glucose tolerance impairment... yet. My blood pressure is still only borderline for this, ditto my triglycerides.) However, if my blood pressure stays highish while on the D, my doc may call me one of those cases anyway. If he does, I'll have specific medical reason to be South Beaching it. Take THAT, carb zealots! :-)
Monday, May 12th, 2008 07:14 pm (UTC)
I didn't know that a vit D deficiency can cause high blood pressure! I wonder if my mother knows this? She never gets any sun, and won't drink milk (fortified with vit D).
Monday, May 12th, 2008 07:42 pm (UTC)
The link is fairly newly discovered and as far as I can tell it's still being investigated. Does your mother have high blood pressure? Of course, she may be getting enough vitamin D from fish and the like, if she eats a bunch of that.
Monday, May 12th, 2008 07:23 pm (UTC)
How much sunlight does it take to get your vitamin d? I'm usually only out enough to go from the car to my house. I've got the stupid lactose thing too, but I can get away with cheese and yogurt. But no milk or ice cream. I miss milk. Soy milk is ok, especially the chocolate stuff, but I miss milk.
Monday, May 12th, 2008 07:49 pm (UTC)
I should let [livejournal.com profile] rfrench answer this one, as he's been researching ultraviolet radiation recently. If I remember right, the upshot for pale people is well under an hour under noonday sun -- twenty minutes maybe? O'course, that doesn't say what latitude you're at.

Like you I am usually out only between my car and my house. It was different when I could hike and run and go backpacking (*sigh*).

D is also in a lot of fortified breakfast cereals. And fish. Lots of fish.
Monday, May 12th, 2008 08:17 pm (UTC)
Good to know!

I may have to wander out a bit more :)
Monday, May 12th, 2008 08:26 pm (UTC)
Yeah, go stand on the seashore until you catch a herring with your bare hands, then eat it, and whether you succeed in catching one or not you're probably all set. ;-)
Monday, May 12th, 2008 08:45 pm (UTC)
There are a lot of factors that affect how much sunlight you need. Vitamin D is synthesized by exposure to UV-B radiation. Without going into too much gory detail (I'm currently writing a major paper on a related subject, so I could go on for pages):

- A black person can need 8-12X as much as a pale, white-skinned person
- UV-B decreases with latitude. Above a line from about CA/OR to Boston, insufficient UV-B is available half of the year no matter what you do. (This is probably why we became white to begin with!)
- UV-B increases with altitude. You need less exposure if you're on top of Mt. Shasta.
- Sunscreens, even lame ones, can remove 95% of UV-B.
- UV-B will not penetrate glass or most plastics.

The bottom line is that a normal white person needs to be exposed to midday sun at a mid-latitude (e.g. central California), with a significant portion of their body uncovered (e.g. shorts and a T-shirt), for 10-30 minutes at least several times per week without sunscreen or glass in the way in order to produce a sufficient amount of Vitamin D.

Milk is not a great source of Vitamin D. You would have to drink 10 large glasses a day to get what you need. Milk is explicitly fortified with Vitamin D during manufacturing. Most cheeses and yogurts aren't, so they don't help the problem.

Remember that the USRDA for most vitamins is based on the absolute minimum to survive. The USRDA for Vitamin D is 400 IU, which is just enough to prevent rickets.

I get outside on a daily basis, I don't use sunscreen, and I drink a fair amount of milk, but I was recently tested and am also somewhat Vitamin D deficient. I think this is probably a huge problem for the average person who works in a building and only gets sun going to or from their car.
Monday, May 12th, 2008 11:06 pm (UTC)
That is fascinating! My sister is a nurse and I asked her and she was going to look it up online because now she was curious, but I read this to her. Fascinating.

Thank you!

:)
Tuesday, May 13th, 2008 03:41 am (UTC)
Excellent information, thank you so much for sharing!

I noticed a general improvement in health and vitality when I made a point of going for a walk outside every day at work. That got me thirty minutes outdoors with no sunscreen, usually around noon. Could be because it gets me out of the bloody office, but it actually is one of the therapies suggested for SAD, which I have in spades. I bet I've also improved my vitamin D production.

CJ, have you looked into learning more about things that help and hinder absorbtion of Vitamin D and other vitamins? It may be worth investigating, if one is eating things that interfere, or doing other things that interfere, one might take tons in but still not be at an adequate level. I am short on time and can't dig into it, but I'd suggest you do.

I know for B12, one thing that can interfere with absorbtion is the phytates in soy protein. For a person who is either vegetarian or an omnivore who consumes large amounts of soy every day, this can lead to poor absorbtion of B12, which if unchecked for sufficient time can have some Very Nasty Side Effects. I don't know this from personal experience, but know a person who went through this. Total reversal of their symptoms upon some heavy B12 supplementation and some diet changes.

Checking into absorbtion factors can be very very useful. Oh, the calcium thing.. in the absence of vitamin D, calcium is not absorbed as well. My first ph.d. advisor did research on that before entering her current field. So, promoting a better level of vitamin D may also improve bone density, over time with a good calcium intake.

Good luck and hugs from your friendly neighborhood biochemist.
Monday, May 12th, 2008 09:05 pm (UTC)
A bit of clarification on the milk. The NIH claims that one cup of milk is 25% of the US RDA. Of course, whether the US RDA truly is all you need... *snort*.
Tuesday, May 13th, 2008 02:51 am (UTC)
Check out Bio-D Mulsion Forte (http://www.evitamins.com/product.asp?pid=13834). It's great stuff and has 2,000 IU per drop. I took 50 drops the first dose then 2 drops a day for a few months and my Vit D went from near nothing to smack in the middle of normal range. My doc said this form is the most easily used by the body.