D'oh Vitamin D

[FionaGFG]

This week I've mostly been looking like this picture of Homer. After too much laptop work I buggered up my back muscles. Note to self - heed those twinges! However, a recent trip to my GP did unearth some good though

a) it is muscular (phew)

b) I did actually need another vitamin D injection (my last one was in Feb when I felt like death warmed up) and discovered I was severely deficient (despite having had a nice holiday in the sun)

So this blog is a la Seasme Street style dedicated to VITAMIN D!

PSSST Speed read?

>Overloaded on mondays? Then just skim this Web MD slideshow on all you need to know about Vitamin D instead.Simples! medicinenet.com/nutritional...

VITAMIN D

> Why is it important?

Major vitamin D functions

* Supports key mineral absorption and metabolism (especially calcium and phosphorus in the blood and bones)

* Regulates normal cell differentiation and proliferation (e.g., prevention of cancer)

* Promotes insulin sensitivity and blood sugar regulation (insulin secretion)

* Regulates over 200 genes through binding to vitamin D receptors throughout the body

In essence think of Vitamin D as the oil that means your machinery works effectively and efficiently. Low levels of Vitamin D have been linked to other diseases like Thyroid, Osteoporosis and MS so it's important to ensure that you're not deficient can try and prevent deficiency.

>How do we get enough Vitamin D?

Broadly speaking normally from sunlight (at least 20mins without sunscreen) and from oily fish and eggs. However, as Coeliacs our stomachs have been damaged by the battle with gluten. Therefore we often won't process Vitamin D without a good jump start.

There are two forms - D2 is found in some foods and D3 is produced within the body when the skin is exposed to sunlight.

Dietary vitamin D2 is found naturally in egg yolk, mackerel, cod and halibut liver oils, salmon and sardines. Vitamin D is also added to some foods. In the UK, margarine has to be fortified with vitamin D by law. In the US milk is fortified with vitamin D.

>Why is Vitamin D important for Coeliacs?

Well in actual fact half of the UK is Vitamin D deficient (so says Patient.co.uk). We can blame that on our pesky lack of sunlight! However, it's important for Coeliacs as we often won't absorb it correctly as the stomach plays a bit role in processing it via the sun and eggs and oily fish. As one of the key vitamins that is converted into a hormone in the body it plays a key role in thyroid function, bone strength, and cell function.

>What are the symptoms of Vitamin D Deficiency?

I can vouch for these common symptoms (and not having a head full of grey hair yet I decided to see my GP in Feb last year and ask what was wrong)...

>fatigue after climbing a few steps

>lack of energy

>muscle cramps and spasms

>tiredness

>depression

>sexual hormone imbalances (which affects men & women)

So... don't just write off your ailments as getting old!

There's even some discussion on this website between Vitamin D Deficiency, weight gain, Poly Cystic Ovaries, and hormone functions:

"Vitamin D deficiency may contribute to the wide set of disorders associated with metabolic syndrome (syndrome X), as well as to PCOS. In a study published in 2004, the authors saw a 60% improvement in insulin sensitivity in healthy, vitamin D replete adults — and concluded vitamin D was more potent than two prescription medications commonly used to treat type 2 diabetes! But the cadres of drug reps spread out across America are not likely to be reminding your healthcare practitioner about this study. They are not likely to have heard about it!"

womentowomen.com/healthynut...

>Vitamin injections / supplements

If you are vitamin D deficient from your blood test your Dr may prescribe a Vitamin D injection to give you an immediate boost, followed by another in 6mths time. Alongside you may be given vitamin D3 and calcium supplements to take each day.

Do note - that you may have to work hard for your vitamin injection. There is a UK shortage and only one supplier!

So find a friendly pharmacist and ask them to ring around for you. Do ensure that your Dr also writes the correct prescription. I say this myself after learning I have been prescribed a measure which the pharmacist doesn't stock, so after a few phone calls and another chat with the Dr I am on track for the required amount of 600,000 units/ml

1x2ml ampules.

> Be informed...Radio 4

The brilliant BBC radio 4 recently did a whole feature on Vitamin D. Do have a listen on iPlayer or your PC. You'll learn much more about why Vitamin D is important, how recommended levels vary worldwide and why leading research is debunking the myth that people can overdose on Vitamin D. Obviously we always recommend seeking medical advice before popping vitamins and supplements. Yet if you're informed about new research you can have a productive chat with your Dr.

Sadly like going 'gluten free' vitamin D deficiency has had a bad rap due to Celebs jumping on the 'healthy' bandwagon. So persevere, and take a print out from Coeliac UK or Patient.co.uk if you don't think your vitamin D levels have ever been checked or you think your symptoms match the common list above.

>Listen & Learn...

bbc.co.uk/iplayer/episode/b... 2010

plus

bbc.co.uk/programmes/b00s0djn

"Traditionally lack of Vitamin D is linked with poor bone health, but new studies suggest that milder deficiency may also be linked to asthma, some cancers and diabetes. Dr Mark Porter investigates and hears from a night shift worker who had such excruciating pain in her hands she thought that she had arthritis - when her doctor checked for vitamin D levels, 3 weeks of supplements cured the pain"

Low Vitamin D and MS

news.bbc.co.uk/today/hi/tod...

VIDEO:

Have a look at our new You Tube Channel and Dr Vikki's handy overview of Vitamin D3 deficiency in Coeliacs.

youtube.com/user/GlutenFree...

LINKS:

Want to know more? Read up on these handy links and ask your Doc what your vitamin D levels are at your next check up:

patient.co.uk/health/Vitami...

bbc.co.uk/search/vitamin_d

vitamindcouncil.org/researc...

womentowomen.com/healthynut...

en.wikipedia.org/wiki/Endoc...

fightingfatigue.org/?p=1220

[philaustin]

Thorough, in-depth report Fiona, thanks! You mention D2 and D3; D2 from foods and D3 from sunlight. The tabs I take are Adcal D3. Each containing 10 microgrammes of D3. So I get 10 microgrammes of D3 daily. Is this okay?

<b>Updated on Nov 1 2010 5:02PM:</b> Sorry, 2 tabs = 20ug /day.

[FionaGFG Administrator]

Phil, it's hard for me to comment as I'm not a Dr - if only I'd been less scared of blood and good with figures eh! However, patient.co.uk is well worth a read. It recommends this level of Vitamin D for maintenance to avoid deficiency "Adults need 400 IU per day. For people who get little sunshine, and in the elderly, this should be doubled to 800 IU." If you're unsure you're on the right amount the best bet is to book in and see your Dr and ask for a blood test. There are different levels and types of Vit D that are prescribed in the UK. Also bear in mind that Coeliac's should get yearly blood tests to monitor Vit B12, Vit D, and iron (as we're often deficient in these due to stomach damage, our GF diet and other auto-immune diseases like Pernicious Anemia). Blood pressure and Cholesterol should also be checked as these can alter due to the gluten free diet, as we're obviously eating less whole grains. Here's a handy check up list from Coeliac UK's site which is always a handy starting point for talking through with GPs that aren't familiar with Coeliac Disease:coeliac.org.uk/healthcare-p...

Sadly although NICE guidelines were released this year for diagnosis of Coeliac Disease there are yet to be guidelines on management of Coeliac Disease. We're sure that will come in time. In the mean time this is a very handy guide from the British Society of Gastroenterologly,

"Patients require regular dietetic support with the opportunity or access to a gastroenterologist should further problems arise. Follow-up may be in primary or secondary care as long as the support is adequate (as noted previously).In patients with persisting symptoms they should be investigated carefully with particular reference to ensuring that refractory coeliac disease is excluded."

bsg.org.uk/sections/small-b...

[philaustin]

I take the medicine as prescribed by the GP and have to trust that he knows what he's doing. I also hope that he'll send me for the right blood tests when they are due. That's the best I can do I guess.

[FionaGFG Administrator]

Phil I'm sure your Dr knows what he's doing. No harm asking for the Vit D test when you next have a check up though. After a number of years GF our absorption of key vitamins and nutrients should improve.