Dear Dr. Roach: I was wondering if听you can give me any advice on听dealing with my diagnosis of听low听vitamin D.
I have been plagued by this for years. My problem is compounded by severe GERD, which makes it impossible to take vitamin D supplements.
I have tried sublingual drops, gummies, tablets and gel caps with no success. None听of my physicians has come up with听a听solution. Their responses range from听鈥淚 don鈥檛 know鈥� to 鈥渏ust suck it up.鈥�
I have been offered 50,000-IU pills, which is the standard treatment for this, but if I can鈥檛 tolerate even two tabs at 400 IU, I don鈥檛 see how I can take 50,000 IU without any stomach distress.
Do you know of any other alternatives to oral supplements? I have tried 10,000 IU of听a topical cream, which was not successful. I was tested after one month of this regimen.
I am 67 years old and in fairly good health. I could feel better, since I have fatigue and a lot of aches, especially at night and upon waking.
P.B.
I occasionally hear from people who are unable to take medications due to side effects, such as the stomach upset you get from taking vitamin D. It sometimes needs a creative approach.
I can think of three possibilities. The most direct would be to use an injection of vitamin D.
A recent research paper showed that an injection of 300,000 units of vitamin D led to much higher blood levels at three and six months.
The second would be to let听your body鈥檚 own system work. Your skin can synthesize very large amounts. It鈥檚 estimated that by exposing a large area of skin, such as your back, to direct sunlight, you听can make between 10,000 and 25,000 units of vitamin D in the time it takes your听skin to turn a light pink colour.
Repeated sun exposure increases risk of听skin cancer, however.
Third, I don鈥檛 know how your GERD is听treated, but most people can get excellent relief with a combination of lifestyle changes and medication. A very, very few听are treated surgically. I wonder if听your听GERD is not being adequately treated.
Finally, I often have mentioned the placebo effect, where people take a medication that they think will help and get relief, even if the medication is ineffective (such as a 鈥渟ugar pill鈥�). There is a similar phenomenon called the nocebo effect, where people get side-effects from a medication if听they are convinced it will cause side-effects.
This happens even if the medication shouldn鈥檛 cause any. I don鈥檛 know if that is the case in you.
听
Dear Dr. Roach: I have been diagnosed with听glossitis by my doctor. I was told to have vitamin B-12 shots.
However, some online medical sources claim that there is no cure, nor do they accurately know what it comes from. Do you have an opinion on this?
J.R.D.
鈥淕lossitis鈥� means 鈥渋nflammation of the tongue.鈥�
Atrophic gastritis is a particular form, in听which the tongue is smooth, shiny and reddened, that is sometimes associated with nutritional deficiency, including iron and vitamin B-12, but also Sjogren鈥檚 syndrome, candida infection and celiac disease.
I would be surprised if you were recommended B-12 shots without a definitive diagnosis, which is easy to make after blood听testing. It鈥檚 important to make a diagnosis, because the other causes are听potentially serious and are treated very听differently.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
听
