Ask Dr. H: Vitamin D is important; get enough

Question: My doctor drew my Vitamin D level and is recommending that I take 50,000 units of Vitamin D once a week. That sounds like a lot to me. At 58 years of age, how important is Vitamin D?

Answer: Vitamin D, the "sunshine vitamin," is a whole lot more important to our health than most people realize. It's the hottest vitamin under study these days, with new studies coming out every month showing how supplemental Vitamin D may protect against osteoporosis, heart disease, ovarian cancer, colon cancer, kidney cancer, prostate cancer, Parkinson's disease, multiple sclerosis, dementia, fatigue, psoriasis, tuberculosis, and colds/flu.

Did you ever notice that colds and flu are worst in winter when sunlight and Vitamin D levels are at their lowest?

We know there are a lot of health conditions that Vitamin D may help, yet about 50 percent of folks have low levels. A normal level (measured as a 25-hydroxy Vitamin D level) is between 30 and 100, with a target of at least 50 to 60 for optimal disease prevention. A toxic level of Vitamin D is greater than 200, and it's really difficult to exceed that limit with daily or weekly Vitamin D supplementation.

The U.S. Recommended Daily Allowance advises a conservative dosing of 400 to 600 units of Vitamin D per day, failing to consider that individual Vitamin D levels may still show deficiency. I've had several patients, including a pilot and a software engineer, with undetectable Vitamin D levels!

Milk contains only 100 units of Vitamin D per 8-ounce glass. If you live north of the latitude line of Atlanta, no amount of sunshine in winter can raise your level. A rough rule of thumb is that every 100 units of Vitamin D taken daily will raise your Vitamin D blood level by 1. With supplementation sufficient to achieve a 25-hydroxy blood level of 50 to 60, I recommend monitoring the Vitamin D and calcium levels every three months.

Q: On a recent flight, I observed how the flight attendants passed out bags of peanuts to passengers. What if there were a passenger with a serious allergy to peanuts? With peanut dust inhaled in a closed space, isn't that a risky practice at 32,000 feet?

A: Peanut allergy is dangerous if you have it. For most folks, peanuts are an excellent source of protein and nutrients. But for a small percentage of folks, peanuts, or even foods containing trace amounts of peanuts, can be lethal.

While the peanut allergy may only cause hives, some people may suffer a life-threatening allergic reaction called "anaphylaxis." The lips and throat swell, there's difficulty swallowing or breathing, and the person may die if not treated in time.

For those who have peanut allergy, life is a challenge. Besides avoiding peanuts and peanut butter, they need to watch out for foods that may contain traces of peanuts. Some examples: candy, especially chocolate products; pastries and cookies; Chinese and Thai food, including egg rolls; chili; packaged foods; and hydrolyzed plant or vegetable protein.

Airline travel can be especially hazardous for those with a serious peanut allergy. A 2008 study published in the Annals of Allergy, Asthma and Immunology showed that nearly one in 10 people with peanut, tree nut, or seed allergies experienced an allergic reaction while traveling on an airplane.

Most of these reactions occurred by inhaling airborne particles from peanuts. This occurred after multiple bags of peanuts were opened near a person with peanut allergy. Airborne peanut particles seem to be common on airplanes, since peanut proteins have been found in the ventilation filters of commercial airplanes.

My advice to those with a serious peanut allergy would be to avoid, if possible, any airline that serves peanuts on a planned flight. I'd also carry an EpiPen as well as an antihistamine like Benadryl or Zyrtec. Medical alert bracelets are also advisable to alert others that one has a peanut allergy.