Summer in Wisconsin

It's been a glorious summer in Wisconsin.

For weeks straight, we've enjoyed bright, sunny days with temperatures in the 70s and 80s. Even now, in late September, our windows are wide open and the days are warm and sunny. Yesterday, it was 84 degrees. Yes, it did rain for a stretch of about 10 days in August, but for the most part it has been a wonderfully sunny summer.

So it struck Andy as a big surprise when we checked his 25-OH-vitamin D3 blood level: 15 ng/ml--severe deficiency.

"I don't get it. I'm outside almost every day. Look at me! How do you think I got this tan?"

Indeed, Andy sported a nice dark tan over exposed areas.

In fact, Andy was among the dozen or so people this month with deficiencies of this magnitude.

Deficiency is not the exception; it is the rule. Of course, if Andy's blood level is at the level of severe deficiency in September, he will only trend lower over the next few weeks and months. He would likely have shown vitamin D blood levels of <10 ng/ml by January--profound deficiency.

With deficiency of this severity, Andy has been exposing himself to risk for prostate and colon cancer, diabetes and metabolic syndrome, low HDL, higher triglycerides, higher blood sugars, higher C-reactive protein, osteoporosis, arthritis . . .

Correcting the deficiency is easy. But, as you can see, getting sun is not always the answer. Even with an active, outdoor lifestyle and a tan, Andy still remained significantly deficient. Oral replacement with vitamin D3, or cholecalciferol, is an absolute necessity.

Comments (10) -

  • Bad_CRC

    9/25/2007 2:17:00 PM |

    Dr. Davis, what dose did you prescribe Andy?  I'm curious because mine was 14.3 in August, after several lengthy outdoor activies and (I thought) much sun exposure.  I've been taking 4000 IU/day and will re-check soon, but perhaps I should have started even higher.

  • Dr. Davis

    9/25/2007 10:58:00 PM |

    I suggested that he begin with 6000 units of a gelcap D3 per day. I suspect his eventual dose will lie somewhere between 6000-10000 units per day.

    However, the dose is based on body size, age, sex, and some other factors.

  • Anonymous

    9/26/2007 6:17:00 AM |

    Dear Dr Davis,

    Thanks for your very informative blog.

    Have you any idea why some people apparently don't make proper amounts of cholecalciferol when they are exposed to UV-B?

    I know this inability is rather common in the elderly, but younger people should make plenty of vitamin D when outdoors in September.

    Thanks in advance for your reflection.

    Melle Mulder
    The Netherlands.

  • Dr. Davis

    9/26/2007 11:46:00 AM |

    The capacity for vitamin D-generation in the skin is tremendously age-related. Dr. Michael Holick has published data to this effect. I have seen it in real life.

    For instance, I saw a 81-year old man recently who is a clear-cut sun-worshipper, complete with dark leather-like skin. He is outdoors in Wisconsin in summer, Florida in winter. 25-OH-vitamin D3 level: 7 ng/ml--profound deficiency.

    Yet a 25 year old may have a blood level of 42 with modest and occasional sun exposure.

    I am unsure of the explanation behind the age-dependent loss in capacity. It will be fascinating to see if a basic researcher somewhere provides an explanation.

  • over&out

    9/29/2007 8:44:00 PM |

    Dr Davis, My wife(type 2)thin and exercising, was having trouble keeping her #'s down, 170 -180. Even on 4 X Metf. After seeing all your info on D3 I was cross checking over on PubMed and saw a couple studies of D3 benefiting Diabetics. She cautiously started taking a 1000IU in oil base gel capsule daily, 2 weeks ago and her counts have been slowly dropping into the 120's. I am sending her off for blood draws this week to see where she is at.
    Ever hear of such a thing? We are VERY happy and grateful to you. XXX000 (from my wife)

  • over&out

    9/29/2007 8:44:00 PM |

    Dr Davis, My wife(type 2)thin and exercising, was having trouble keeping her #'s down, 170 -180. Even on 4 X Metf. After seeing all your info on D3 I was cross checking over on PubMed and saw a couple studies of D3 benefiting Diabetics. She cautiously started taking a 1000IU in oil base gel capsule daily, 2 weeks ago and her counts have been slowly dropping into the 120's. I am sending her off for blood draws this week to see where she is at.
    Ever hear of such a thing? We are VERY happy and grateful to you. XXX000 (from my wife)

  • Dr. Davis

    9/29/2007 11:02:00 PM |

    Yes. Though variable, I have witnessed this effect many times. Vitamin D facilitates insulin responses.

    I love when wonderful, beneficial effects derive from simple solutions,  don't you?

  • Anonymous

    1/26/2008 3:55:00 AM |

    Dr. Davis: Last March, per your recommendation, I started on a vitamin program which includes niacin, fish oil, DHEA, magnesium citrate and Vitamin D.  Before that time, I had been quite ill for about 3 years with either a cold or the flu.  It seemed like I could never get over these illnesses.  Well I'm happy to report that I have not been sick one day since March, 2007!  I have been watching my diet and exercising more as well.  I have stayed on the 6,000 mg of Vitamin D and I truly have seen the benefits.  In addition, my blood pressure has dropped to a normal level - thank you!

  • Dr. Davis

    1/26/2008 5:08:00 AM |

    That's fabulous!

  • Anonymous

    7/2/2008 3:01:00 AM |

    Dr. Davis,

    If a person uses sunscreen every time he or she is outdoors, it's my understanding that the body will not make D3.  But if a person doesn't use sunscreen and is outdoors every day in Wisconsin during the summer, will he still need to take D3?

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Heart Defects Simplified

Heart Defects Simplified



For as long as I've known him, echocardiography technologist, Ken Heiden, has had a deep fascination with congenital heart disease. Ken has just written a wonderful book on congenital heart disease called Heart Defects Simplified.

While this is a bit off-topic for the Heart Scan Blog, I know that there is a serious lack of helpful information for people with congenital heart disease and parents of children with congenital heart defects. So I asked Ken to tell us something about his book.



WD: I've reviewed your book and have been thoroughly impressed with the clarity and detail with which you handle a complicated topic. You somehow manage to make it easy to grasp, far more than any other resource I've used in past. Do you feel that your book serves a previously unmet need?

KH: This book serves an unmet need in that it presents the complex subject of congenital heart defects in a simplified manner. Most books on this subject are anywhere from 300-1700 pages in length and tend to be written for doctors. Further, most of these books have very few diagrams, and they rely upon their explanations to describe these defects.

Heart Defects Simplified is 104 pages in length, describes the most common defects, including surgical repairs, in a two-page format with full-color diagrams on the left and complete descriptions on the right of each chapter. The book is particularly written for sonographers, nurses and parents, but it is valuable for anyone interested in this subject. It is particularly useful in clinical situations because it is convenient to lay out at your side with a coil-bound format and durable pages. Further, there are appendixes which include "Surgical Procedures in Alphabetical Order," "Prevalence of Congenital Heart Disease," "Scanning Protocols for Echocardiographers," "Imaging Tips," a glossary and a worksheet for echocardiographers.


WD: I know that many people with loved ones who have congenital heart defects, particularly parents of children with such conditions, are often kept in the dark about the details of the condition. Is your book suitable for the non-technical reader, such as parents?

KH: This book is an excellent resource for parents. It is written in language that is understandable by parents as well as technologists and nurses. The full-color diagrams provide invaluable insight into this very complex world. Most importantly, this book attempts to make the subject of congenital heart defects accessible to anyone who wishes to comprehend this subject.


WD: I understand that people with congenital heart defects and parents are active participants in online discussion groups. Will your book serve as a resource for people who participate in these groups?

KH: This book is not only a resource for sonographers and parents, but the book is accompanied by a blog (HeartDefectsforEveryone.blogspot.com) that attempts to address many of the concerns commonly encountered with congenital heart defects. This blog is a work in progress, but I hope to provide a forum for parents, healthcare personnel, and others to share their questions and concerns about congenital heart disease.
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