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Vitamin D Deficiency














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Professional Columns -
Weight Loss Today by Dr. Margaret Gaglione





VITAMIN D DEFICIENCY

Hard to believe in 2009 that we would have a profound nutritional deficiency present in our society, especially in the Hampton Roads area with Virginia Beach's sand and sun.  Unfortunately, as the quality of our nutrition declines, and as our degree of adiposity increases, our industrial nation is rapidly becoming a nation of "malnourished" vitamin-deficient, obese individuals.

Vitamin D deficiency is of particular interest to me as many of my overweight patients frequently complain of generalized poorly localized pain, poor sleep secondary to pain, and fatigue; many have been diagnosed with fibromyalgia. For many of these patients, it is hard to tell which occurred first - the symptoms of fatigue or their weight gain; for many it is just a vicious cycle.


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Vitamin D deficiency leads to the formation of excess, poorly formed bone, and weak muscles. In addition to its obvious link to osteoporosis, Vitamin D deficiency has been linked to generalized bone and muscle pain, and a higher incidence of cancers, particularly colon cancer.  Patients with severe vitamin D deficiency may develop a waddling gait known as Trendelenburg gait secondary to muscle weakness and reduced reflexes without muscle wasting.

Vitamin D is essential for the proper absorption of calcium. The body can produce vitamin D from the ultraviolet rays of the sun or absorb it from vitamin D fortified foods such as milk, certain dairy, cold-water fish, organ meat, and eggs. The increased avoidance of the sun due to the fear of skin cancer, more time spent indoors because of work, avoidance of milk products due to lactose intolerance, higher use of sun block, less consumption of cod, herring, mackerel, and organ meat have all increased our risk of vitamin D deficiency.

Overweight and obese patients are at particular risk also because of poor nutritional habits, low fortified food intake, fatty liver disease and decreased sun exposure. Vitamin D deficiency is the most common vitamin deficiency in patients who have undergone gastric bypass surgery.

One of our patients came to us with multiple medical issues and a vitamin D level of 17. After losing more than 95 pounds in nine months, he is off all his pain/mood/sleep medication. His other issues have resolved with his weight loss and improved exercise capacity.

Ask your health care professional to check your vitamin D level at your next physical. Normal levels are 32-100.




Dr. Gaglione is the medical director of Tidewater Bariatrics in Chesapeake. She is a board certified Internal Medicine physician and a Bariatric specialist.











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