Posts Tagged ‘osteoporosis’

Erectile Dysfunction and the Other “Bones” That Are Important

September 4, 2016

I would like men to think of erectile dysfunction as a harbinger of other chronic diseases like heart disease, diabetes, kidney failure, high blood pressure, elevated cholesterol levels and also bone disease or osteoporosis.

A recent study from Taiwan 4,460 men aged 40 years and older diagnosed with erectile dysfunction from 1996 to 2010 with 17,480 randomly selected age-matched patients without ED.  The research found that osteoporosis developed in nearly 6% with ED and 3.65% in men without ED.  Men who had ED had a 3 times more likelihood of developing osteoporosis when compared with men who did not have ED.

Osteoporosis is a metabolic bone disease in which the bones become brittle and porous escalating the rate of bone loss and increasing the chance of a fracture of the hips and spine.

The researchers think that the men with ED had a lower level of testosterone which is necessary for bone strength and development.  Another explanation offered by the authors is that chronic, low grade inflammation can damage the lining of the blood vessels and perhaps lead to a decrease in the blood supply to the penis which is necessary for an erection to occur.  The same inflammation can also cause the bones to fail in calcium rebuilding of bone and thus lead to osteoporosis.

Finally, there is the theory that there is alternation of the vitamin D with decreased levels in men with ED.  With less vitamin D there is a risk of alternations in the lining of the blood vessels especially those that supply the penis and lead to ED.  Decrease in vitamin D also alters bone metabolism and may result in osteoporosis.

Bottom Line: Men with ED should be check for the co-morbid conditions such as heart disease, diabetes, high blood pressure, hormone deficiency and also have tests to be certain that men do not have osteoporosis.

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What steps can people take today to ensure healthy aging in their future?

September 18, 2015

I am frequently asked by patients about how to grow old gracefully and in good health. Unfortunately, the fountain of youth has not been discovered. However there are steps that everyone can take to make the senior years enjoyable ones providing we have our mental and physical health. This blog will provide some suggestions that I think can lead you to healthy lifestyle in your middle age and older years.

The risk of Alzheimer’s disease
One in eight adults above the age of 65 years old in the United States has Alzheimer’s disease and some cognitive decline is a normal part of aging. The greatest known risk factor for Alzheimer’s is advancing age. The likelihood of developing Alzheimer’s doubles about every five years after age 65 and after age 85, the risk reaches nearly 50 percent.

Those who have a parent, brother, sister or child with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness.

Genetics (heredity) also plays a role. There are two types of genes that can play a role in affecting whether a person develops a disease—risk genes and deterministic genes. Alzheimer’s genes have been found in both categories. Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Deterministic genes directly cause a disease, guaranteeing that anyone who inherits them will develop the disorder.

So what can you do?
Live an active life. Regular exercise is one of the greatest keys to physical and mental wellbeing. Regular exercise may prevent or even provide relief from many common chronic conditions, including heart disease, diabetes, depression and arthritis

Maintain your brain. Studies have shown that a lifestyle that includes cognitive stimulation through active learning slows cognitive decline. That means getting off the couch and onto the sidewalks, parks, or jogging paths. A brisk walk 20-30 minutes a day is all that you need.

Get enough sleep. Older adults need just as much sleep as young adults – seven to nine hours per night. Lack of sleep can cause depression, irritability, increased fall risk and memory problems

Make an effort to reduce stress. Long-term stress can damage brain cells and lead to depression, memory loss, fatigue and decreased ability to fight off and recover from infection.

What are some foods people can eat now for healthy aging later?
Eat nutrient-dense foods like fruits, vegetables and whole-grains to keep your body and mind sharp.
Colorful fruits and vegetables contain antioxidant which help stop unstable molecules from damaging healthy cells. I suggest you consume colorful vegetables and fruits, such as leafy greens, tomatoes, blueberries and carrots as they contain the highest quantities of antioxidants. You want to enjoy five to nine servings a day.

You need calcium and vitamin D. The calcium and fortified vitamin D in dairy foods are crucial to strong bones and help prevent osteoporosis. I suggest 3 cups of low-fat milk, yogurt, or other dairy products a day.

Whole grains are rich in fiber and help lower cholesterol and provide for regular bowel movements. Examples are oats, quinoa, barley, wheat and brown rice, which also lowers your chance of developing type 2 diabetes and keeps blood vessels in peak condition. You should strive for three servings of whole grains a day.

Fish contains omega-3 fatty acids in fatty fish help protect your heart, lower your odds of having a stroke and may even help guard against Alzheimer’s disease. Help yourself to two servings a week of fatty fish such as salmon or tuna.

Finally, maintain a healthy sex life. Sex serves as a form of exercise and can help reduce stress, improve moods and increase overall health. Another advantage of regular sex is that it can actually lower your total cholesterol level, and increase the high-density lipoproteins (HDL) or the good cholesterol. And besides….it’s a lot of fun!

Bottom Line: You can’t change your genes or your parents but you can lead a healthy lifestyle by having a regular exercise regimen and having a healthy diet. Both of these will lead to good health and enjoyment of your senior years.

10 Medical Tests You MAY Be Able To Do Without

May 15, 2014

For years I have been writing and speaking on wellness and taking good care of yourself using preventive healthcare measures. Now with greater understanding of risks and benefits of tests, I am informing you of some tests that you may want to reconsider.

1. Nuclear stress tests, and other imaging tests, after heart procedures
Many people who have had a hear bypass, stent or other heart procedure feel they’ve had a brush with death. So patients — and doctors — understandably want to be reassured through a nuclear stress test or other tests that their hearts are beating strong. But performing these tests every year or even every two years in patients without symptoms rarely results in any change in treatment. In fact, post bypass or stent nuclear stress tests, can lead to unnecessary invasive procedures and excess radiation exposure without helping the patient improve. Instead, patients and doctors should focus on what does make a difference in keeping the heart healty: managing weight, quitting smoking, controlling blood pressure and increasing exercise.
2. Yearly electrocardiogram or exercise stress test
A survey of nearly 1,200 people ages 40 to 60 without any symptoms had an EKG over the previous five years. The problem: Someone at low risk for heart disease is more likely to get a false-positive result than to find a true problem. This could lead to unnecessary heart catheterization and stents. Instead, have your blood pressure and cholesterol checked. And if you’re at risk for diabetes, have your blood glucose level checked as well.
3. PSA to screen for prostate cancer
Cancer is always scary, but the PSA test often finds slow-growing cancers that won’t kill men. As a result of the test, he says, men often have ultrasounds, repeat lab tests and even biopsies for a problem that isn’t there — an estimated 75 percent of tests that show high PSA levels turn out to have negative prostate biopsies. When men do have treatments such as surgery or radiation, 20 to 40 percent end up with impotence, incontinence or both.
The American Urological Association, which supports the use of PSA testing, says that it should be considered mainly for men ages 55 to 69. After age 70, men without any urinary symptoms probably do not need further PSA testing.

4. PET scan to diagnose Alzheimer’s disease
Until recently, the only way to accurately diagnose Alzheimer’s was during an autopsy. In the last few years, doctors have begun using PET scans with a radioactive dye to look for beta-amyloid protein that is found in the brains of people with the disease. Although this test has promising use for research, there are serious questions about whether it should be used on those who complain of a fuzzy memory. PET scans in older people consistently find the protein in 30 to 40 percent of people whose memories are just fine.

5. X-ray, CT scan or MRI for lower back pain
Unfortunately, back pain is incredibly common — 80 percent of people, myself included, will suffer from back pain some time in their lives. It can be both excruciating and debilitating. Naturally, people want to know what’s wrong. Here’s the catch: The best imaging machines in the world often can’t tell them. Many older people with no back pain can have terrible-looking scans.
Most back pain goes away in about a month and imaging tests tend to lead to expensive procedures that often don’t help recovery. However, if your legs feel weak or numb, you have a history of cancer or you have had a recent infection, see your doctor as soon as possible.
6. Yearly Pap tests
The yearly Pap smear is a common part of women’s health checklists, but it doesn’t need to be. Women at average risk only need them every three years, since cervical cancer generally takes 10 to 20 years to develop. If women have also had negative tests for the human papillomavirus (HPV), which is now known to cause the cancer, they only need a Pap test along with the HPV test every five years. And women older than 65 who have had several normal Pap tests in a row can stop having them altogether. Do note, however, that a yearly visit to an ob-gyn stays on the to-do list.
7. Bone density scan for women before age 65 and men before age 70
For the estimated 10 million people — mainly women —in the United States who have osteoporosis, bone-strengthening medications can lower the chances of breaking a bone. But many experts argue that for those ages 50 to 65 who have osteopenia — mild bone loss — testing and subsequent drug prescriptions may be a waste of time and money. Not only is the risk of fracture often quite low, medications such as Fosamax (alendronate) and Boniva (ibandronate) have been linked to throat or chest pain, difficulty swallowing, heartburn, muscle pain, bone loss in the jaw and thigh-bone fractures. And there’s scant evidence that people with osteopenia get much benefit from the drugs.
To help keep your bones strong, try walking and weight-bearing exercises. Get enough calcium and vitamin D in your diet. If you smoke, quit.
8. Follow-up ultrasounds for small ovarian cysts
Many women receive repeated ultrasounds to verify that ovarian cysts have not become cancerous, but current research says that these tests aren’t necessary. For one thing, premenopausal women have harmless ovarian cysts regularly. For another, about 20 percent of postmenopausal women also develop harmless cysts.
The likelihood of these small simple cysts ever becoming cancer is exceedingly low.
In postmenopausal women, only cysts larger than 1 centimeter in diameter need a follow-up ultrasound. For premenopausal women, who typically have benign cysts every month when they ovulate, cysts smaller than 3 centimeters aren’t even worth mentioning in the radiologist’s report, says Levine.

9. Colonoscopy after age 75
Most people should have screening for colon cancer at 50 and then every five to 10 years after that, if the first test is normal. By age 75 — if you’ve always had normal colonoscopies — you can stop taking this test altogether. That should be good news, because a colonoscopy can cause serious complications in older people.
Just the preparation for colonoscopy can be exceptionally harsh. Some patients become incontinent or experience weeks of pain, diarrhea and constipation. In worst cases, the procedure can perforate the colon. Despite such risks, recent studies have found that substantial numbers of people over 75, even over 85, are still getting screening colonoscopies.
To protect your colon, eat plenty of fruits, vegetables and whole grains for fiber. Cut down on fatty foods, red meat and processed meats. Lose weight if you’re overweight and exercise. Sound familiar? It should, because that’s the best advice for protecting the rest of your body — and mind — as well.
10. Yearly physical
There’s little evidence that having an annual checkup can keep you healthy. Many tests that doctors regularly perform — to diagnose anemia, liver disease or urinary tract infections, for example — don’t make sense unless there’s a reason to suspect a problem. A healthy 52-year-old does not need to see the doctor once a year.
Certainly, if you have an illness that needs treatment, you should see your physician. And do talk to your doctor about how often you need to have your blood pressure and cholesterol tested. For these other tests, ask your doctor if they really are necessary and is the screening worth the risk of the procedure and are the benefits greater than the risks.

Restoring The Fountain of Youth-DHEA Just May Be The Youth Hormone For Women

January 28, 2014

American women (men too) are always looking to find a way to turn back the biologic clock. We all would like to look like the women in Cosmopolitan and Vogue Magazines. If your goal is to look younger, feel better, and improve energy level, then you might consider the benefits of DHEA.

DHEA, dehydroepiandrosterone, is a hormone produced in the adrenal gland, the small triangular structure that sits on top of the kidneys. DHEA is made by the adrenal glands and is then converted to androgens, estrogens and other hormones. These are the hormones that regulate fat and mineral metabolism, sexual and reproductive function, and energy levels. DHEA levels increase until our mid to late 20′s then gradually decline. DHEA is a very powerful precursor to all of your major sex hormones: estrogen, progesterone, and testosterone. (Its molecular structure is closely related to testosterone). DHEA is called the “mother hormone” — the source that fuels the body’s metabolic pathway.

When DHEA levels are low, your body does not have enough working material for proper endocrine function. This throws off your hormone production and you feel a general sense of malaise, along with other symptoms of hormonal imbalance — how severe depends on how many other demands are being made on your body at the same time.
There is a growing body of evidence that healthy levels of DHEA may help stave off Alzheimer’s disease, cancer, osteoporosis, depression, heart disease and obesity, but there is still no clear-cut consensus. There may be some increased risks associated with DHEA for women with a history of breast cancer — all the more reason to take DHEA under medical supervision.

Symptoms of low DHEA include extreme fatigue, decrease in muscle mass, decrease in bone density, depression, aching joints, loss of libido, and lowered immunity.
DHEA is stated to be possibly effective for these conditions:
1. Aging Skin – Taking DHEA orally seems to increase epidermal thickness, sebum production, skin hydration, and decrease facial skin pigmentation in elderly men and women
2. Osteoporosis – Taking DHEA orally 50-100 mg per day seems to improve bone mineral density (BMD) in older women and men with osteoporosis or osteopenia.
3. DHEA is also thought to contribute to a sense of well-being when used by those with adrenal and/or androgen insufficiency.
4. It may also support lean body mass in postmenopausal women.

DHEA has many potential benefits but does also have some side effects, which include hair loss, hair growth on the face (in women), aggressiveness, irritability and increased levels of estrogen. Calcium channel blockers may increase DHEA levels and those using calcium channel blockers should avoid supplementation. Anyone with a history of hormone-related cancer such as estrogen sensitive breast cancer should definitely avoid DHEA due to the probability of increased estrogen levels.

If you don’t feel DHEA is appropriate for you, it may be possible to increase the body’s natural production of DHEA with regular exercise and restricting the number of calories you consume. Calorie restriction is associated with a longer life span and the increase in DHEA production may be partially responsible. In fact, there are many studies that show you can improve your DHEA levels naturally by maintaining a body mass index of 19-25, getting adequate rest and exposure to sunlight, exercising regularly (including sexual activity), and fostering more “downtime” in your life — but more on that in a moment.

Without a medical test it’s impossible to know what your DHEA levels are. Using blood tests, your doctor can check for estradiol in the follicular phase (usually days 3–9 of a menstrual cycle); progesterone in the luteal phase (days 14–28); DHEA-S; and both free and total testosterone levels.
Treatment With DHEA Supplements

If tests indicate the need for DHEA supplementation, you may start off with as little as 1-5 mg, twice a day. The dosage can be slowly increased to 10–12 mg per day. Most doctors do not suggest any woman exceed 25 mg per day if capsule forms are used. Once balance has been restored and symptoms even out, most women produce enough DHEA on their own.

Bottom Line: Many women are suffering from hormone imbalance. Decreased DHEA can be a cause of many problems affecting middle age women and can even impact her libido and her energy levels. DHEA should never be taken casually or unsupervised, but its benefits are real for the women who need it.

Preventive Healthcare For Women – What You Need To Know

January 21, 2013

Women have had an interaction with the healthcare profession from birth to old age. They have achieved good health as a result of frequent visits to their doctors and practiced good health habits. This blog is written for the purpose of providing women with suggestions for continuing the process of maintaining good health.

Why Screening Tests Are Important
Remember that old saying, “An ounce of prevention is worth a pound of cure”? Getting checked early can help you stop diseases like cancer, diabetes, and osteoporosis in the very beginning, when they’re easier to treat. Screening tests can spot illnesses even before you have symptoms. Which screening tests you need depends on your age, family history, your own health history, and other risk factors.

Breast Cancer
The earlier you find breast cancer, the better your chance of a cure. Small breast-cancers are less likely to spread to lymph nodes and vital organs like the lungs and brain. If you’re in your 20s or 30s, your health care provider should perform a breast exam as part of your regular check-up every one to three years. You may need more frequent screenings if you have any extra risk factors.

Screening With Mammography
Mammograms are low-dose X-rays that can often find a lump before you ever feel it, though normal results don’t completely rule out cancer. While you’re in your 40s, you should have a mammogram every year. Then between ages 50 and 74, switch to every other year. Of course, your doctor may recommend more frequent screenings if you’re at higher risk.
Cervical Cancer
With regular Pap smears, cervical cancer (pictured) is easy to prevent. The cervix is a narrow passageway between the uterus (where a baby grows) and the vagina (the birth canal). Pap smears find abnormal cells on the cervix, which can be removed before they ever turn into cancer. The main cause of cervical cancer is the human papillomavirus (HPV), a type of STD.
Screening for Cervical Cancer
During a Pap smear, your doctor scrapes some cells off your cervix and sends them to a lab for analysis. A common recommendation is that you should get your first Pap smear by age 21, and every two years after that. If you’re 30 or older, you can get HPV tests, too, and wait a little longer between Pap smears. Both screenings are very effective in finding cervical cancer early enough to cure it.
Vaccines for Cervical Cancer
Two vaccines, Gardasil and Cervarix, can protect women under 26 from several strains of HPV. The vaccines don’t protect against all the cancer-causing strains of HPV, however. So routine Pap smears are still important. What’s more, not all cervical cancers start with HPV.
Osteoporosis and Fractured Bones
Osteoporosis is a state when a person’s bones are weak and fragile. After menopause, women start to lose more bone mass, but men get osteoporosis, too. The first symptom is often a painful break after even a minor fall, blow, or sudden twist. In Americans age 50 and over, the disease contributes to about half the breaks in women and 1 in 4 among men. Fortunately, you can prevent and treat osteoporosis.
Osteoporosis Screening Tests
A special type of X-ray called dual energy X-ray absorptiometry (DXA) can measure bone strength and find osteoporosis before breaks happen. It can also help predict the risk of future breaks. This screening is recommended for all women age 65 and above. If you have risk factors for osteoporosis, you may need to start sooner.
Skin Cancer
There are several kinds of skin cancer, and early treatment can be effective for them all. The most dangerous is melanoma (shown here), which affects the cells that produce a person’s skin coloring. Sometimes people have an inherited risk for this type of cancer, which may increase with overexposure to the sun. Basal cell and squamous cell are common non-melanoma skin cancers.
Screening for Skin Cancer
Watch for any changes in your skin markings, including moles and freckles. Pay attention to changes in their shape, color, and size. You should also get your skin checked by a dermatologist or other health professional during your regular physicals.
High Blood Pressure
As you get older, your risk of high blood pressure increases, especially if you are overweight or have certain bad health habits. High blood pressure can cause life-threatening heart attacks or strokes without any warning. So working with your doctor to control it can save your life. Lowering your blood pressure can also prevent long-term dangers like heart disease and kidney failure.
Screening for High Blood Pressure
Blood pressure readings include two numbers. The first (systolic) is the pressure of your blood when your heart beats. The second (diastolic) is the pressure between beats. Normal adult blood pressure is below 120/80. High blood pressure, also called hypertension, is 140/90 or above. In between is prehypertension, a sort of early warning stage. Ask your doctor how often to have your blood pressure checked.
Cholesterol Levels
High cholesterol can cause plaque to clog your arteries (seen here in orange). Plaque can build up for many years without symptoms, eventually causing a heart attack or stroke. High blood pressure, diabetes, and smoking can all cause plaque to build up, too. It’s a condition called hardening of the arteries or atherosclerosis. Lifestyle changes and medications can lower your risk.
Checking Your Cholesterol
To get your cholesterol checked, you’ll need to fast for 12 hours. Then you’ll take a blood test that measures total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, and triglycerides (blood fat). If you’re 20 or older, you should get this test at least every five years.
Type 2 Diabetes
One-third of Americans with diabetes don’t know they have it. Diabetes can cause heart or kidney disease, stroke, blindness from damage to the blood vessels of the retina (shown here), and other serious problems. You can control diabetes with diet, exercise, weight loss, and medication, especially when you find it early. Type 2 diabetes is the most common form of the disease. Type 1 diabetes is usually diagnosed in children and young adults.
Screening for Diabetes
You’ll probably have to fast for eight hours or so before having your blood tested for diabetes. A blood sugar level of 100-125 may show prediabetes; 126 or higher may mean diabetes. Other tests include the A1C test and the oral glucose tolerance test. If you’re healthy and have a normal diabetes risk, you should be screened every three years starting at age 45. Talk to your doctor about getting tested earlier if you have a higher risk, like a family history of diabetes.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It’s spread through sharing blood or body fluids with an infected person, such as through unprotected sex or dirty needles. Pregnant women with HIV can pass the infection to their babies. There is still no cure or vaccine, but early treatment with anti-HIV medications can help the immune system fight the virus.
HIV Screening Tests
HIV can be symptom-free for many years. The only way to find out if you have the virus is with blood tests. The ELISA or EIA test looks for antibodies to HIV. If you get a positive result, you’ll need a second test to confirm the results. Still, you can test negative even if you’re infected, so you may need to repeat the test. Everyone should get tested at least once between ages 13-64.
Preventing the Spread of HIV
Most newly infected people test positive around two months after being exposed to the virus. But in rare cases it may take up to six months to develop HIV antibodies. Use a condom during sex to avoid getting or passing on HIV or other STDs. If you have HIV and are pregnant, talk with your doctor about reducing the risk to your unborn child.
Colorectal Cancer
Colorectal cancer is the second most common cause of cancer death after lung cancer. Most colon cancers come from polyps (abnormal masses) that grow on the inner lining of the large intestine. The polyps may or may not be cancerous. If they are, the cancer can spread to other parts of the body. Removing polyps early, before they become cancerous, can prevent it completely.
Screening for Colorectal Cancer
A colonoscopy is a common screening test for colorectal cancer. While you’re mildly sedated, a doctor inserts a small flexible tube equipped with a camera into your colon. If she finds a polyp, she can often remove it right then. Another type of test is a flexible sigmoidoscopy, which looks into the lower part of the colon. If you’re at average risk, screening usually starts at age 50.
Glaucoma
Glaucoma happens when pressure builds up inside your eye. Without treatment, it can damage the optic nerve and cause blindness. Often, it produces no symptoms until your vision has already been damaged.
Glaucoma Screening
How often you should get your eyes checked depends on your age and risk factors. They include being African-American or Hispanic, being over 60, eye injury, steroid use, and a family history of glaucoma. People without risk factors or symptoms of eye disease should get a baseline eye exam, including a test for glaucoma, at age 40.
Bottom Line: It’s good health sense to talk with your doctor about screening tests. Some tests, such as a Pap test or breast exam, should be a routine part of every woman’s health care. Other tests might be necessary based on your risk factors. Proper screening won’t always prevent a disease, but it can often find a disease early enough to give you the best chance of overcoming it.

WSYDD-What Should Your Doctor Do?-Suggestions For Dialog With Your Primary Care Doctor

June 21, 2011

According to the National Physicians Alliance, these are five guidelines that your primary care physician should follow:

 

1. Don’t do imaging for low back pain within the first six weeks.  Although low back pain is the fifth most common reason for all physician visits, X-rays of the lumbar spine before six weeks does not improve outcomes but does increase costs.

 

2. Don’t obtain blood chemistry panels (glucose, calcium, uric acid) or urinalyses for screening in asymptomatic, healthy adults.  It is recommended to do lipid screening (cholesterol, triglycerides) which yields significant numbers of positive results even among asymptomatic patients.  It is appropriate to screen for diabetes with a glucose test in asymptomatic adults with hypertension

3. Don’t order annual ECGs or any other cardiac screening for asymptomatic, low-risk patients.  There is little evidence that detection of heart disease in asymptomatic patients at low risk for coronary heart disease improves health outcomes.  False positive results are common and false-positive tests are likely to lead to harm through unnecessary invasive procedures, over-treatment, and misdiagnosis

4. Use only generic statins (Mevacor® (lovastatin) Pravachol® (pravastatin),Zocor® (simvastatin) when initiating lipid-lowering drug therapy.  All statins are effective in decreasing mortality, heart attacks, and strokes when dose is titrated to effect appropriate LDL-cholesterol reduction.  It is acceptable to switch to more expensive brand-name statins (atrovastatin [Lipitor] or rosuvastatin [Crestor]) only if generic statins cause clinical reactions or do not achieve LDL-cholesterol goals

5. Don’t use DEXA screening (test for bone mineral density) for osteoporosis in women under age 65 or men under 70 with no risk factors.  This test is not cost effective in younger, low-risk patients, but is cost effective in older patients

Bottom Line: So What Should Your Doctor Do?  He or she should weight the potential harms of routine annual screening to make sure the harms are much less than the potential benefit.  Only with a meaningful dialog should routine testing and screening be performed in asymptomatic young men and women.

Take Vitamin D and See-A Vitamin You Can’t Be Without

October 26, 2010

In the past vitamin D was thought to be responsible for growth and stability of your bones.  Now we have found that vitamin D is responsible for a dozen other medical conditions including stroke, depression, asthma, high blood pressure, heart attacks, prostate cancer as well as osteoporosis or weak bones.

Vitamin D is readily available from you skin which makes Vitamin D when your skin is exposed to sunlight.  Just 10-15 minutes of sunlight twice a week is usually sufficient to generate all the vitamin D you need.  However, excessive exposure may increase your risk of skin cancer.  Unfortunately as people get older the skin is not as effective to make vitamin D and older people need vitamin D supplements.

Vitamin D is available in cod liver oil, fatty fish such as salmon, mackerel, sardines, and tuna fish.  Egg yolks, cereals, and fortified milk are other sources.  Supplements containing 1000-2000 international units are usually helpful sources of the vitamin if you can’t get adequate amounts through your food.  Vitamin D supplements are best taken with the largest meal of the day as food appears to help the absorption of the vitamin.

Doctors can check your vitamin D level with a blood test.  A blood level of less than 20ng\ml indicates a deficiency while levels 21-29ng\ml indicate a vitamin insufficiency and should require supplementation.

Bottom Line: Vitamin D deficiency is more common than we thought and can lead to more than soft bones.  Get your vitamin D level check at least annually and if you are “down a pint” put some back in your tank with inexpensive supplements.