Health Matters

It’s an epidemic on Lopez, probably throughout all of Washington, and probably throughout our country.

It’s an epidemic on Lopez, probably throughout all of Washington, and probably throughout our country.

About six months ago I read a study directed at post-menopausal women living most of the year in the state of Florida. The study tested these women for vitamin D levels in their blood. About 25 percent of them were quite low. There is lots of sun in Florida – lots. But as one travels north, light exposure drops off and therefore so does vitamin D. Made by the skin when exposed to light, the vitamin is hard to come by as one travels north. Then there are people like me who tell patients to avoid the sun in order to prevent skin cancer. Without sunlight, the only significant source of vitamin D is either fish liver (think cod liver or whole sardines) or taking a vitamin D supplement. I turns out that almost no one is doing either of those adequately.

How bad is the Lopez Island vitamin D epidemic? In a number it is 93 percent. That is to say over 90 percent of the people we have tested have been frankly low or borderline low on their vitamin D level. The normal level for vitamin D serum level is 32 to 100. I am finding the average value on the island is somewhere in the 20s. Endocrinologists (doctors who specialize in diseases of hormones, vitamins, etc.) like to see a D level of about 45.

What happens if you are lacking in vitamin D? We know that it affects bone growth. Vitamin D helps the gut to absorb calcium, so no D then poor absorption. Low D is also related to higher rates of colon cancer and heart disease. There is work being done to investigate a connection between vitamin D deficiency and multiple sclerosis. We also know that “all cause mortality” drops if people take vitamin D. All cause mortality means how many people die from any and all causes of death. I suspect that other problems and disease may be found to be linked to the vitamin as research continues. On a personal note, when I pass away, I want it to be from all cause mortality.

What to do. Well, fixing this particular health problem is actually pretty easy. First is the test for vitamin D, which is done through a simple and painless brain biopsy here at the clinic. We use a nice, clean pair of brain pliers which fit easily into the ear canal. A few quick twists, and voile! Or if you wish, a blood test is also available. Once the lab result is back, if you test low, then a high dose vitamin D, 50,000 units, is given once a week for eight weeks followed by a daily oral dose of 2000 units forever. It sounds like an awful lot, but consider that you, on a hot, sunny day, standing buck-naked outside, at noon, would be arrested. Oh, and you will also will produce about 15,000 units of vitamin D in a mere 30 minutes. There are only a handful of recorded vitamin D overdoses in the medical literature and these were among people who took ridiculous amounts for long periods of time while standing buck-naked outdoors for way more than 30 minutes. Honestly, I don’t know if the regimen mentioned above will be enough. Although we have treated many people, very few so far have had follow up testing. About half of those who have been treated remained in the lower or borderline levels.

So there are your choices: brain biopsy or blood test, big piles of festering fish livers or vitamin D pills. You decide. I’m okay either way.