Medical Mish-Mash for May

A little alliteration there, but how about Vitamin D, diabetes, and depression? Let’s start with Vitamin D.

By now, we should all know about this essential nutrient and the critical functions it serves—bone health, proper heart and muscle functioning, even the potential of staving off some forms of cancer. Today we’re interested in how it might affect our immune systems. A large study published in the British Journal of Medicine looked at this, and the relationship between vitamin D and the occurrence of respiratory infections—upper (colds and sinusitis) and lower (such as pneumonia). These infections are important, causing an estimated 2.5 million deaths each year around the world. What these researchers found was that vitamin D supplementation reduced the incidence of respiratory infections by 10-15%. That’s not 100%, but it’s significant. It didn’t seem to matter whether your blood level was low or normal at the beginning of the study, though people with low levels to start with had a greater reduction in infections. And while individuals of every age benefited, those of us younger than 15 years showed the greatest benefit.

This makes sense, considering some of the actions of this vitamin as it impacts our immune systems. But how much is enough? And can you take too much? Well, you can take too much of anything, but adults who take 2-3,000 units of vitamin D3 each day shouldn’t have any problems. In fact, it turns out that those who took it daily had the greatest benefit. If you have children (that group under age 15), talk with your pediatrician. Correctly dosed, it won’t cause any problems, and it might lessen these all-too-common infections.

Now what about diabetes? This is another significant problem for us, and all too common. Some experts estimate that as many as 1 in 8 Americans suffer with this disease. That’s a lot, and many of us with diabetes experience slowly healing wounds and skin ulcers. Interestingly, that’s one of the tip-offs for the presence of undiagnosed type-2 diabetes. Many of these wounds are difficult to resolve, requiring weeks and even months of treatment. Recent evidence suggests there may be help here—something easy and inexpensive. It appears that many diabetics (and also many without the disease) have decreased vitamin C levels. That’s not something we routinely check in our office, but when it’s found in diabetics with a non-healing ulcer and corrected, the wound heals. Zinc is another nutrient that when deficient can also cause these problems.

So what do we do with this information? I am now telling all my patients with diabetes to take vitamin C daily. A good dose would be 1 gram twice a day—twice because of the way we metabolize the vitamin. And I tell them to take a zinc supplement a couple of times a week. As a matter-of-fact, I’m telling all my patients to do this, diabetes or not. Very little chance of harm, and a significant upside. I wish everything was that simple.

And finally, let’s talk about depression. If you’ve never experienced a true depressive episode, good for you—and cross your fingers. Most of us will encounter this at least once in our lives. Winston Churchill did, on a fairly regular basis, calling it “the black dog.” Descriptive, because it bites us and holds on, robbing us of energy and motivation, but mainly it steals our joy in living. This can be treated, but if it could be prevented, wouldn’t that be great?

Nothing works 100% of the time, but an article in Preventive Medicine tells us that the incidence of depression can be reduced by as much as 50-75% by increasing our cardiorespiratory fitness level. That means exercise, and though we don’t yet know the magic intensity or duration of this exercise, a good place to start is 30 minutes a day of the equivalent of brisk walking. That’s all. And the benefits extend far beyond preventing depression.

So, take your vitamin D, take your vitamin C (and maybe zinc), and get moving.

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