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.
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. Margaret
MacKrell Gaglione is the Medical Director of Tidewater Bariatrics
in Chesapeake, a practice dedicated to the care of overweight
and obese patients. She is a board certified Internal Medicine
physician and Bariatric Specialist.
Always
Consult Your Physician before beginning any Diet or Exercise Program.
