Dear Dr. Roach: I recently had a test and got a call from my doctor’s office saying my vitamin D level is 29 ng/mL. I immediately had to start taking 50,000 IU once a week for 12 weeks. I don’t understand how I could be deficient in the sun vitamin when I live in South Florida and am often outside and exposing my skin. I also walk my dog, garden, play golf, and drive a convertible. I don’t wear sunscreen and I consume a lot of vitamin D-fortified foods.
I also take a calcium supplement and 500 units of Vitamin D twice a day. I do not have Crohn’s, Ulcerative Colitis, Celiac Disease or any other malabsorptive disease. There is no mention of vitamin deficiency on the warnings for any of the medications I take. This just doesn’t make sense to me. How can this happen? — Anonymous
Other advice
A: First, a level of 29 ng/mL is within what most experts consider to be acceptable, so I don’t see why you’re making a panicked phone call. Very large studies of vitamin D supplements have shown no benefit to fractures, cancer, heart disease, brain function, or many other outcomes when used in people like you. I reserve prescribing vitamin D for people with very low levels, usually people with risk factors that you don’t have.
Why aren’t your vitamin D levels high? Some people have genetic conditions that prevent them from optimally producing vitamin D, even in the presence of sunlight. People with darker skin tones are more likely to have low levels because they have a lower ability to produce vitamin D. However, a level of 29 ng/mL is not something to be too concerned about.
Finally, taking 50,000 units per week for 12 weeks will definitely raise your vitamin D levels, but when you stop taking them, they will eventually go back down to the levels you were at unless you increase your supplement intake. This isn’t much of a problem for you, as 29 ng/mL is fine, but people with very low levels or osteoporosis may want to treat it with weekly vitamin D and not take ongoing supplements after the course is over.
Dear Dr. Roach: Recently, in a balance training class, an expert told me, “Your 80s are tough.” I just turned 75. Is there anything I can do to get through my 80s and stay in good shape? — MR
A: Several of my patients tell me they had a great life into their 80s and had no problems. But most people find that as they get older, they are more susceptible to medical conditions. Unfortunately, some of these cannot be prevented, but there are certainly some tips I can offer older readers who want to maximize their health.
First, your choices really matter. Start with a healthy diet: cut down on processed foods and simple sugars (especially sugary drinks), eat plenty of fruits and vegetables, and consume high-quality sources of protein. Regular exercise is also important: balance training is effective and helps prevent falls, as is strength training. Aerobic exercise, especially at moderate intensity, reduces the risk of heart disease. Regular health checks remain important, including blood pressure measurements, preventive care screenings, or visits to see if any new concerns arise.
Dr. Roche regrets that he cannot respond to each letter individually, but will incorporate as many as possible in his column. Readers can send their questions to ToYourGoodHealth@med.cornell.edu Or mail it to 628 Virginia Dr., Orlando, FL 32803.
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