JANUARY 13, 2011 STICKS AND STONES MAY NOT BREAK MY BONES, BUT LOW VITAMIN D CAN

" I'm always ready to learn, although I do not always like being taught" Winston Churchill

I am always ready to learn. I love learning new things. I never used to like being criticized or judged, but it doesn't bother me anymore. I am who I am. That should say it all. Have I changed? YES. Have you changed? Everyone does not know everything? We all could use a lesson or two. These could either be life lessons or educated lessons on various topics.

I was the oldest student in my Botany training. At first it bothered me in this way. I had thoughts running through my mind --why am I here? Am I too old for sitting in a classroom? Am I too old to camp outside? I do not have the right gear to be wild crafting herbs in the woods... What happens if I get bit by a tick?

I learned invaluable information. I felt young again. I was among individuals who are my own children's age. It felt thrilling. I felt invigorated to be sitting in a classroom.

I often wonder why individuals stop learning after formal education. There is so much to learn. There is not enough time to learn everything. This is why I read, read and read. Last night I was reading my Natural Beekeeping book. I also blocked a new needlepoint canvas. Tonight I must just read my antique Sauer's 'Herbal Cures'.

I started hospital rounds yesterday. I love teaching as well as learning. I always get reacquainted with diseases not usually seen in the office setting. It stimulates me to read medicine either from textbooks or on-line journals. I always want to see if I can write up a case report with a resident, intern or medical student. It is refreshing to sit and teach. It is always a memorable experience for me. Why do I do it? I teach to not only review conventional medicine with the hospital team, but to open their minds to other medical modalities such as herbs, acupuncture, prolotherapy, and nutrition. I am still amazed that 'true' Nutrition is not taught in medical school.


While on hospital rounds I was amazed at how many of the patients want to see the attending. It is not as if the residents/interns are not doing their job. They are doing an excellent job. The older patients need to talk to the attending. After talking to 'Marilyn' she genuinely felt better. She even smiled, despite her upcoming surgery. I am grateful and blessed to be able to make rounds for patients.


You know I consider Nutrient of the Decadeto be Vitamin D. There is never too little to talk about when it comes to Vitamin D. I even mentioned it in hospital rounds today. As stated previously the new data suggests that the health benefits extend beyond healthy bones.

There are two forms of vitamin D: Vitamin D2 and Vitamin D3, ergocalciferol and cholecalciferol respectively. Vitamin D3 is produced from the skin response to sunlight. Few few foods have a high content of Vitamin D3. If you think your source of dairy is giving you the amount of Vitamin D you need--think again. I would definitely recommend everyone take Vitamin D. You can use both vitamin D2 and Vitamin D supplementation. Also, you can have both of these vitamin D levels tested in a blood (serum) sample.

What is more amazing is that a single 20 minute dose of summer sun bathing can provide you with 15,000 to 20,000 IU of vitamin D3. When is your next warm vacation?
My medical knowledge of Vitamin D taught in medical school was limited to the clinical manifestations of vitamin D deficiency which included nutritional rickets, poor skeletal health, and osteomalacia.

There was no mention of Vitamin D benefits as we know today. There is an overall lower mortality rate in those patients taking Vitamin D3, as well as a lower cardiovascular mortality. There is a reduced risk of diabetes, a reduced risk of cancer, a reduced risk of multiple sclerosis, reduced risk of allergies, reduced risk of infection, reduced risk of mental illness and less musculoskeletal pain. Evaluating the evidence regarding Vitamin D overall health benefits is difficult. More studies need to be conducted. There is the National Institute of Health study over a 5 year period evaluating 2,000 IU VitD3 compared to placebo. This will be a good study to refer to however I would have liked to see a higher dose used. On the current recommendations it is wise for those individuals greater than 65 years of age to take 1,000-2,000 IV/day. I have not seen untoward effects in those patients taking more. Serum (blood) levels should be monitored when a patient is taking Vitamin D3.


I do NOT feel skepticism should be maintained on Vitamin D intake and its benefits.

Such is life...

The Decade Nutrient

March 20 2010 First Day of Spring - Sun and Flowers


Being the first day of spring, I want to discuss what I believe is the Nutrient of the Decade, Vitamin D. Why not? Today, the first day of spring, the temperature will be about 72 degrees. In medical school I was taught to use vitamin D with caution . We all should know by now that it is a fat soluble vitamin. Increased levels can increase serum calcium levels. It is not only a vitamin. It has been found to be a pro-hormone and can be expressed in the brain, heart, skin, prostate and even the mammary glands. Everyone associates Vitamin D with bone. Prior to new studies, the RDA requirements were only 400-800 mg. Today, the average is 1000-1200 mg.

I have been using more than 2000-5000 for the past decade, and now even more depending on the patient's serum Vitamin D 25 level (calcidiol), which is the correct measurement despite the fact that in medical school we were taught only to measure the Vitamin D1, 25 (calcitrol). The average (optimal) level ranges from 32 - 100 mg/ml depending on the lab. I prefer someone having a level of 50-60 mg/ml. Severely deficient is 0-15 and mildly deficient is 15-31.

You may think you do not like to take supplements so what food source can you get Vitamin D from? 1 tablespoon is equivalent to 1,360/serving--salmon (3oz sockeye) is 794 IU/serving and milk (nonfat, fortified with D) is 115-126 IU/serving. After yesterday's discussion about milk, I would prefer the fish or the cod liver oil. But the easiest way is supplementation in capsule or liquid form.

As a preventive practitioner in all respects, Vitamin D can decrease your risk of cardiovascular disease, osteoporosis and cancer. When explaining levels of Vitamin D to patients, I state anyone who lives above the imaginary line drawn from Los Angeles east to Columbia, South Carolina needs extra Vitamin D. Yes, in the summer, those of us who sun bathe will get Vitamin D2 which will convert to D3, but in the winter months you should increase your D dosages. However, you may use too much sun block to even get the Vitamin D2 from the sun. You need to walk in the sun three times a week for 15 minutes to get adequate levels if you are using sun block. Remember: not all sunlight Vitamin D2 will convert to D3 unless your small intestines, especially the villi, are free to absorb and make Vitamin D and the good bacteria in the colon are plenty. These good bacteria, like lactobacillus, bifidum, etc. can be taken as probiotics.
Other conditions which predispose someone to a low Vitamin D level, are kidney disease and celiac disease.

Remember this point: Dietary sources of Vitamin D are limited so SUPPLEMENT Vitamin D3.

It is my hope that your 21st century search for serenity is fulfilled in any form of needlework. It is also my hope that you, who live in this technological, mechanical and toxic environment, benefit from the hours you spend with the needle in your hand.

The needlepoint of flowers was a special one. I made it for "Gaga" for her 90th Birthday. Gaga is Rick's grandmother. We celebrated her 90th at the Jefferson Hotel in Richmond, Virginia. This grand hotel opened in 1895. It symbolized a dream for the most colorful citizen of that time, Lewis Ginter. It incorporates Renaissance and other forms of architecture. I felt grand walking down the majest 36-step marbled staircase. It appears that David O. Selnick and MGM copied this for Scarlett O'Hara stairs at Tara.

Until her death in May 2005, she drove her car to the Piggly Wiggly, the hair dresser and to get her mail. She died peacefully, sitting on the couch with needlework in hand. She is surely missed by all.

Until tomorrow...