Punxsutawney Phil saw his shadow today. Six more weeks of winter. But NINE more weeks before we can get ANY Vitamin D from the sun in Iowa. Here the sun is high enough off the horizon only 5 months of the year. Even in the summer very few Iowans make enough of their own Vitamin D.
In all of 2013 I saw fewer than ten patients with good vitamin D levels from only: Multiple Vitamins & Minerals, Calcium Plus D Supplements, “Vitamin D Enriched” Milk, and Sunshine combined. Every other patient needed an additional 1000 IU to over 5000 IU Vitamin D3 supplements daily.
Tertiary HyperParaThyroidism is becoming common among older individuals. Or maybe we are just beginning to notice what it really is. The blood tests are the same as Primary HyperParaThyroidism – high Calcium and high PTH. But the cause and treatment are very different.
Tertiary HyperParaThyroidism happens when Secondary HyperParaThyroidism has been going on for so long that the “thermostat is reset too high”. The ParaThyroid Glands have been maintaining a high PTH level for so long that they forget to shut off when Calcium levels are high enough.
Again we have a patient whose Spine BMD has dropped despite good osteoporosis medication. She takes 500 mg Calcium at breakfast and at supper. She remembers that you can only absorb 5-600 mg Calcium at a meal. But what about lunch? She needs at least 200 mg more calcium in her day.
She plans to eat a yogurt for lunch. This would get her to her minimum of 1200 mg Calcium daily – if only she remembered more than once a week. We need to entice her with a “nooner”. We need her to crave her calcium. Adora Premium Chocolates could do it.