Vitamin D deficiency results in fatigue, high BP, joint pain

Q. As a physician, I have been testing my patients for 25-hydroxy vitamin D for several months. Many are deficient, and some have symptoms of pain and muscle weakness.

I advise patients to take one or two vitamin D supplements of 1,000 units daily. Many pharmacists are not aware of the new information, and some have discouraged my patients from buying such supplements if they are taking multivitamins with 400 International Units per daily dose. Please write about this issue.

A.Fatigue, high blood pressure and joint and muscle pain are just a few of the possible symptoms associated with vitamin D deficiency. Researchers are reporting high rates of this condition because few people spend much time outside, especially during the winter. During the summer, conscientious use of sunscreen can block vitamin D formation.

Experts are now recommending daily doses of vitamin D in the 1,000 to 2,000 range. Although pharmacists may worry about the potential for vitamin D toxicity, this appears to occur only at much higher doses.

Q. I have heard that an ingredient in plastic called bisphenol A can get into foods and beverages from containers.

How can I avoid plastics with bisphenol A?

A. There is a raging controversy about the safety of bisphenol A (BPA) found in polycarbonate plastics. This compound mimics estrogen. Water bottles, baby bottles and the lining of metal cans often contain BPA. Plastic containers may be marked with the recycling code “7.”

Q. I have read that using decongestant nasal sprays can be addictive. What are your views on using oral OTC cold remedies for more than seven days? Will these cause any symptoms when I stop?

A. There is considerable controversy about the effectiveness of the readily available oral decongestant phenylephrine (Annals of Pharmacotherapy, March 2007). Such drugs seem less likely to cause rebound nasal congestion, but they may raise blood pressure in susceptible individuals. Since there is doubt about their benefit, we generally don’t recommend them.

Q. I was diagnosed with celiac disease and advised to avoid gluten from wheat, rye and barley. Avoiding gluten in my diet has made a huge difference for me. Are there any resources to help me avoid gluten in pills?

A. In celiac disease, ingesting gluten triggers the immune system to attack the body, especially the small intestine. This interferes with nutrient absorption. The Food and Drug Administration does not require manufacturers to list gluten on drug labels, but you can look up your medicines at www.glutenfreedrugs.com.

X In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com.

2008 King Features Syndicate Inc.