vitamin d.
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Show me later
A few months ago, The Jerusalem Post under
Judy Siegel-Itzkovich's byline ran an article about the importance of
everyone testing for vitamin D deficiency by a simple blood test, which
I read with great interest. Maccabi Health Services decided to
encourage its family doctors to screen for the vitamin as a result of
her queries. I (61 years old) approached my family doctor and asked for
this test (when I was a young baby I suffered from rickets, a result of
vitamin D deficiency; my mother has osteoporosis). The results came
back that I am in fact suffering from a deficiency of vitamin D, and my
doctor sent me to see an endocrinologist who prescribed me vitamin D3
drops - the kind that are given to new babies, but I was told to take
eight drops daily instead of two. Had I not read this article in the
Post, I would have carried on as normal, not knowing my bones were
softening until it was too late.
I would like to know why most of the
population are not advised to be screened for vitamin D. Can rickets be
passed on from parent to child? And why was I prescribed these baby
drops instead of a regular vitamin D supplement like the on my mother
is taking together with Vitamin C?
E.N., Givat Shmuel
Prof. Ted Tulchinsky, an expert on vitamin D supplementation
at the Hebrew University-Hadassah Braun School of Public Health and
Community Medicine, replies:
Vitamin
D was not on the usual "radar screen" of most doctors, but in recent
years there has been an upsurge of interest, and publications in the
professional literature showing vitamin D deficiencies in many age
groups in many countries, including sunny countries such as Saudi
Arabia, Lebanon and Australia. In addition, vitamin D is now better
understood as vital for many health issues including bone health as
well as in prevention of cancer and cardiovascular diseases. Lately
therefore doctors are more concerned about this with more testing for
vitamin D levels and recommendations for routine vitamin D supplements,
which are in Israel given to infants routinely for many years, and they
are now the accepted medical standard for older children and teenagers
by the American Academy of Pediatrics, as well as for adults here in
Israel.
Rickets is not inherited but is due to vitamin D deficiency. It
was assumed by many that Israel is a sunny country and people should
get production of vitamin D in their skin from sun exposure. However,
this varies by season of the year, duration and time of exposure, dress
codes, indoor activity, use of sunscreen, avoidance of sun due to
concern (about skin cancer) and other factors. Haredi, Beduin and
Ethiopian women are especially vulnerable to vitamin D deficiency.
Vitamin D is not abundant in breast milk, thus breastfed infants in
particular need vitamin D supplements. Only one-percent-fat milk in
Israel has been fortified with vitamin D by law for many years, but
unfortunately not the regular 3% milk. The major dairies sell special
milks in cartons with vitamin D and calcium added at much higher
prices.
I am not aware of any special advantage of drops
over tablets, but this is reminiscent of cod liver oil used widely in
Europe and the Americas by our grandparents and great grandparents and
which was successful in wiping out rickets during the 1920s to 1940s.
Unfortunately the older medical treatments were put aside when gross
clinical rickets became less common. The US and Canada adopted
mandatory fortification of all milk in the 1940s, and this is in effect
until today. As said, we have not yet adopted this standard, although
the Health Ministry is currently (and for the past 15 years) working on
changing the milk regulations. I recommend use of fortified milk,
preferably 1% fat for adults, as well as the drops prescribed, and
regular sun exposure for 20 minutes at least five times per week.
Readers welcomes queries from readers about medical problems.
Experts will answer those we find most interesting. Write Rx for
Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question
to Judy Siegel- Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and residence.
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