Vitamin D: Why It’s Easy to Be Deficient

Have you ever seen pictures of children with extremely bowed legs? It is a condition called rickets and it’s from low levels of vitamin D, causing the bones to become soft and weak.

Vitamin D is crucial for bone health. It helps your body keep a good balance of calcium and phosphate in the blood. With low vitamin D levels, children can develop rickets and adults can develop osteomalacia, a condition in which weak bones cause bone pain, fractures, and muscle weakness.

Vitamin D also has many other functions in the body. It helps control the growth of your cells, improves your immunity, provides nerve and muscle strength, and reduces disease-causing inflammation in your body.

Some studies suggest it may help with type 2 diabetes, weight loss, multiple sclerosis, high blood pressure, depression, heart disease, colon cancer, and other types of cancer.

Nursing home residents seem to have significantly fewer falls when they start a daily vitamin D supplement.

While the jury is still out on all of the studies related to vitamin D, we know it is essential that you have enough but not too much so that it becomes harmful. Simply put, you need to have optimal levels of vitamin D.

How Do You Get Enough Vitamin D?

There are 3 ways for you to get vitamin D:

1. Your skin makes vitamin D through sunlight

2. You can get vitamin D from food

3. You can take a vitamin D supplement

Let’s start with the sun on your skin.

As a general rule, exposure of the face, hands, arms, and legs to sunlight 2 to 3 times a week may produce enough vitamin D to stay healthy. Exposure should be about 1/4 of the amount of time it takes for you to get a mild sunburn. Depending on your skin color, this can mean from 5 to 30 minutes of sun exposure between 10 am and 3pm.

It is the ultraviolet B radiation in sunlight that helps your skin make vitamin D. Complete cloud cover reduces this radiation by about 50%. Shade, including the shade from severe pollution, reduces this ultraviolet B radiation about 60%.

How about food?

Surprisingly, there are not too many foods that are naturally high in vitamin D. The following list includes the foods highest in vitamin D:

Vitamin D Measured in IUs:

Cod liver oil, 1 tbsp, 1,360

Swordfish, cooked, 3 oz., 566

Sockeye Salmon, cooked 3, oz., 447

Mackerel, canned, 3 oz., 214

Sardines, canned, 3 oz., 197

Tuna Fish, canned in water, drained, 3 oz., 154

Orange juice Vitamin D-fortified, 1 cup, 137

Milk, Vitamin D-fortified, 1 cup, nonfat, reduced fat, & whole, 115-124

The abbreviation IU stands for “international unit” and is what you will find on food and supplement labels.

The third source of vitamin D is from supplements.

In general, there are two different forms of vitamin D on the market: ergocalciferol (also known as vitamin D2) and cholecalciferol (also known as D3). I will discuss their effectiveness in the following section.

How Much Vitamin D Do You Need?

Well, if you can get enough sun on your skin as described above, you really do not have to worry about getting more vitamin D from food and supplements.

On the other hand, food and supplements can provide a healthy dose of vitamin D if you have any (or a combination) of the following risk factors for low vitamin D:

  • You do not spend enough time outdoors, especially in the sun.
  • You live in a northern latitude, especially north of the Philadelphia-San Francisco line. For example, in Boston, there is not enough sunlight to make vitamin D in your skin for about 4 months of the year. If you go further north to Edmonton, Canada, your skin cannot make vitamin D for 5 months of the year.
  • You have been following your dermatologist’s suggestion of liberally using sunscreen to protect yourself from the sun’s radiation.
  • You have darker skin. Skin pigment reduces the skin’s ability to absorb the ultraviolet radiation in the sun. In a bathing suit, a light-skinned person spending 10-12 minutes under peak July sun in Boston can make 10,000 to 20,000 international units of vitamin D. It will take an Asian Indian person, who has darker skin, about 30 minutes to make as much vitamin D. It will take an African American with very dark skin about 120 minutes to make the same amount of vitamin D.
  • You are obese. Fat cells hoard vitamin D. This reduces the circulating vitamin in your blood.
  • Your have a medical condition such as Crohn’s disease, celiac disease, and cystic fibrosis that impairs your gut’s absorption of vitamin D.
  • You are a strict vegetarian.
  • Your kidneys are impaired so they cannot activate the vitamin D you have.
  • You are older than 65. This means your skin makes less vitamin D, your gut may not absorb nutrients as efficiently, and your kidneys may not activate vitamin D as effectively. Even in sunny South Florida, as many as 40% of older people have low vitamin D levels.

If you have any of these risk factors, how many international units of vitamin D should you aim for a day?

This depends on whom you talk to. In recent years, various scientific authorities came up with different amounts of vitamin D that they consider good for your daily intake through food and supplements.

To spare you the confusing numbers and arguments, here is the bottom line.

If you are an adult, aim for 600 to 2000 IUs of vitamin D a day from your food and supplements.

And if you get vitamin D from supplements, keep in mind that unit for unit, cholecalciferol (vitamin D3) is better used by your body than ergocalciferol (vitamin D2).

In general, vitamin D3 is about 3 times more powerful than vitamin D2.

How Do You Know if You are Vitamin D Deficient?

If you are low on vitamin D, you may have bone pain and muscle weakness. But, often the symptoms of low vitamin D are very subtle. And even without any clear symptoms, low vitamin D can badly affect your health in different ways.

Your doctor can order a simple blood test, 25-hydroxy vitamin D, for you. Again, the normal range for vitamin D also varies according to different authorities. But here is what you need to know: a level of 30 to 50 ng/mL is considered optimal for bone health and overall health.

If your blood test suggests that you are very low on circulating vitamin D, your doctor may give you a prescription for high-dose treatment for a period of time. Make sure you follow his or her directions.

Can You Get Sick From Too Much Vitamin D?

Yes you can!

Too much vitamin D in your body can make you not want to eat, lose weight, urinate excessively, and have abnormal heartbeats. Even more seriously, it can make your blood calcium level too high, resulting in damage to your heart, blood vessels, and kidneys.

Unless you are under close monitoring by you doctor, do not take over 4000 international units of vitamin D from food and supplements a day. Exceeding this dose will increase your risk for having a toxic overload of vitamin D.

On the other hand, your skin will not make too much vitamin D from sunshine. Your body is such a marvelous creation that when you get too much sun, your skin actually rids itself of the extra vitamin D automatically.

Keep reading to discover the keys for defusing ticking health bombs that could be lurking in your body. Click here to discover the medical secrets necessary to know so you can live a better, longer, healthier life.

Using Bodybuilding Supplements To Build Muscle Mass!

OK, first let’s get something straight here…

If you think that buying a shake or taking a few pills will all of a sudden make you huge, then you are mistaken.

No supplement will help you if you are not training and dieting correctly — they will just give you very expensive urine. All aspects of your program have to be in order for you to get the maximum benefit from sports nutrition supplements. From my experience, supplements enhance your program by:

1. Adding an element of convenience: Using food supplements like Meal Replacement Powders and whey protein help to eliminate the common problem of ‘not enough time’, by providing you with an quick efficient way to get your required nutrients each day.

2. Increasing strength and decreasing recovery time: Using vitamin and amino acid supplements help to minimize the negative side effects of weight training and speed your recovery.

The Benefit of Convenience

There are many ‘old school’ trainers and bodybuilders who profess the uselessness of supplements. They are constantly preaching that they don’t work, and that you don’t need them. Well, to tell you the truth they are correct, somewhat. Remember that not too long ago there were no supplements. Bodybuilders built huge physiques without meal replacement powders, creatine or prohormones.

There was no such thing as exercise ‘machines’. They used multi-jointed, compound free weight exercises that not only increased their muscular size, but also make them incredibly strong. So, if you look at that way it can be done and you don’t need any supplements. However, the decision whether or not to use supplements should involve the consideration of other factors that may come into play when speaking of dieting today. The first of which is time.

Many people today just do not have the time to live, eat and breathe food. Very few people like to cook, and even fewer cook on a regular basis. When was the last time that you actually had six meals that you actually cooked yourself? Many of those who are against dietary supplements continue to preach that you should get all the nutrients that you need from your diet. ‘Eat a balanced diet and you will get all the nutrition you need’. Well, 100 years ago that may have been true, but today this type of advice is questionable.

The fact is, most people’s idea of a good meal is restaurant or (even worse) fast food. To ask someone to eat specific amounts of protein, fat and carbs seems like an impossible request considering that most people can’t even get their minimum requirements of good fat or fiber. Experts will continue to spout ‘eat a balanced diet,’ while Americans feast on nutritionless fast food and sugar. Not only do our bodies have to deal with the ever-increasing external stresses of everyday life, they also have to combat nutrient-depleting, tissue damaging exercise.

If I did not have the option to supplement my diet with whey protein, I probably would not have gained as much weight as I have. Now, I’m not saying that the whey protein is why I gained weight, but it did help me a great deal.

I am usually very busy and I just don’t have the time, nor the desire to eat six, planned whole food meals per day. Supplements like meal replacement powders and whey protein fill in this gap for me.

I typically have three real food meals and three protein supplement meals — that makes up my required six meals each day. When I’m away from home, or not able to get an adequate meal, my MRP is always right there when I need it. It gives me a quantifiable amount of protein so that I can keep track of my nutrient intake. In my opinion, this is much better than just grabbing something and then trying to guess at how much protein, fat or carbs you just ate. Getting in all of your required meals and nutrient amounts is crucial to your success.

My mass diet requires a very high daily protein intake — Over 300g per day. Just to give you example of how much that is, here are some examples of what 300g of protein is equal to:

Tuna — 50 oz of canned tuna (the average can is 6-8oz.), which is 1,750 calories and 25g of fat

Chicken — 38 oz of chx breast (equals about seven 6oz breasts), which is 1,313 calories and 38g of saturated fat

Beef — 43 oz of lean ground beef (about 2.7 pounds of meat), which is 3,214 calories and 215g of saturated fat

Eggs — 50 large whole eggs, equals 3,750 calories and 250g of saturated fat

Egg whites — 100 egg whites, equals 1,600 calories and almost no fat

Pure whey protein — 15 scoops of EAS Precision Protein, equals 1,500 calories 7.5g of saturated fat

It is very possible to get this amount from eating whole foods only — But it will take work. Also, as you can see from the above numbers, getting all of your protein from regular food will also bring a lot of unnecessary elements like extra saturated fat. Yes, our goal to gain mass is to eat a lot of calories (including fat), but your main fat intake should consist of unsaturated fats that are liquid at room temperature like olive oil, flaxseed oil, sunflower oil and safflower oil. Whey protein supplements will help to give you the extra protein without the fat.

Increased Strength and Decreased Recovery

In addition to a whey protein supplement, I recommend that everyone should be taking a multi-vitamin, plenty of vitamin C, and glutamine. Creatine can also be added if you are over 18.

Multi-Vitamin

Weight training increases the body’s need for many minerals like magnesium and selenium. The multi-vitamin ensures that I am not deficient in any major essential vitamin or mineral. Deficiency symptoms include muscle weakness and suppression of the immune system, muscle cramping and fatigue.

I always take a multi-vitamin without iron, because grown men do not need additional iron. We get enough from our food. Men and postmenopausal women should never take iron supplements unless they have iron-deficiency anemia, which is only diagnosed by blood tests. The body has no way to eliminate excess iron except through blood loss. Women who menstruate are protected from iron overload, obviously. Iron is also an oxidizing agent that can cause damage to the heart and arteries, and is a major risk factor in arteriosclerosis.

Vitamin C

Vitamin C essential to prevent free radical damage, which is accelerated after the heavy trauma of weight training. It is also essential is helping to repair connective tissue which helps decrease the amount of time you are sore. I train very heavy and extremely hard. When I train my legs, I am usually sore for about 5-6 days afterwards.

If I do not supplement my diet with vitamin C, I would normally be sore for almost 10 days! So, it really helps me to recover and get back to training. I typically take around 3,000mg in divided doses. That would equal quite a few oranges!

Glutamine

Glutamine is an amino acid that is produced by our bodies, but most of the time our bodies demand so much, that it can’t create enough. I supplement my diet with glutamine to increase my levels of glutathione. Glutathione is a powerful antioxidant, which helps to combat the stresses of exercise trauma, and prevent muscle protein breakdown.

I especially believe that it helps prevent my body from breaking down my new muscle while I am asleep, so I never go to bed without taking it. I take about 15g per day (in divided doses), which would be impossible to get naturally.

Creatine Monohydrate

Creatine’s purpose is to supply our muscle with energy. It is also found in red meat, but you would have to eat an enormous amount of meat to get the same benefits as taking pure creatine powder. Everyone knows about creatine so I will not go into it here, but I do want to say that the major benefit from taking creatine is that it will increase your strength.

This will enable you to lift heavier weights, which will stimulate more muscle growth. Many people make a big fuss over the muscle volumizing effects of creatine, because if you stop taking it, you lose that extra fluid that creatine brings into your cells. So what! You certainly DO NOT lose the extra muscle creatine helped you to gain.

I can honestly say that I could not have built the body I have today without the convenience and enhancements supplements provide. I simply don’t have the time or desire to do it any other way. This is a choice that you must decide for yourself. You will be spending your money on these products, so make sure that you know their place in your program.

Don’t get caught up in product hype. Supplements will help, but they will NOT do the work for you.

Do Not Take Supplements Without Diet

If you think that just buying a shake or taking a few pills would all make a sudden difference in you, then you are mistaken.

No supplement would help you if in case there is not proper training and dieting. If you are taking sports nutrition supplements then all the aspect of your program should be in order to get the maximum benefits out of it. Normally supplements improve your program by:

1. Adding a factor of ease: Using nutrition supplements like Meal Replacement Powders and whey protein assist you to remove the usual problem of ‘not having enough time’. It provides you with a fast effective way to get your required nutrients on daily basis.

2. Increasing strength and reduce recovery time: Using vitamin and amino acid supplements assist you to minimize the side effects, which are negative and speed your recovery.

Mass diet need very high protein intake on an every day basis – Over 300g per day. The following examples would help you understand what 300g of protein is equal to:

Tuna – The 50 oz of canned tuna (the average can is 6-8oz) that is 1,750 calories and 25g of fat.

Chicken – The 38 oz of chx breast (equals about seven 6oz breasts) that is 1,313 calories and 38g of saturated fat.

Beef — The 43 oz of lean ground beef (about 2.7 pounds of meat) that is 3,214 calories and 215g of saturated fat.

Eggs — The 50 large whole eggs equal 3,750 calories and have 250g of saturated fat.

Egg whites — The 100 egg whites, equals 1,600 calories and nearly no fat
Pure whey protein — The 15 scoops of EAS Precision Protein, equals 1,500 calories 7.5g of soaked fat.

It is quite possible to get this value from eating whole foods only – But it would take work. Also, as you could see from the above numbers, getting all of your protein from usual food would also bring a lot of needless elements like extra saturated fat. Yes, our aim to gain mass is to eat a lot of calories (as well as fat), but your main fat intake must consist of unsaturated fats, which are liquid at room temperature like olive oil, flaxseed oil, sunflower oil and as well safflower oil. Whey protein supplements would help to give you the extra protein without the fat.

H1B Cap Issues for Physicians

The US. Citizenship and Immigration Service (USCIS) imposes an annual H-1B cap of 58,200 (congressional cap of 65,000 less 6,800 set aside for workers from Singapore and Chile by the Free Trade Act). In addition, USICS exempts from the H-1B cap 20,000 aliens with a U.S. – earned master’s or higher degree. Other exemptions to the cap are available to aliens who are currently in H-1B status or who will be employed at an institution of higher education or a related or affiliated nonprofit entity, or at a nonprofit research organization or a governmental research organization.

Medical Professionals and Strategies Regarding H-1B Transfer Cap Issues:

The limited amount of H-1Bs available each fiscal year poses a wide range of problems to U.S. employers and may have lasting effects on aliens. Many foreign national physicians face unique challenges regarding the H-1B cap upon completion of their residency or fellowship or when they attempt to enter the job market by accepting a private practice position (for example, in the context of someone moving from an employer that is cap exempt to one that is not).

In such cases, a “cap gap” problem may arise if the USCIS improperly interprets INA 214(g)(6), which states that an alien who ceases to be employed by an exempt employer and has not been previously counted should be counted the first time the alien is employed by a non-exempt employer. My opinion, is that INA 214(g)(6) does NOT block such a transfer as long as it submitted as an application to extend status. To the contrary it is my opinion that the numerical restrictions only apply when new H-1 status is sought, that is when the applicant is applying for a change of status to H-1B from a different nonimmigrant status such as the H-4 or B-2 or when consular notification is requested rather than extension of H-1B status.

The basis for this view is a precise reading of the statutory language of INA 214(g) and numerous explicit directives issued by USCIS. Specifically, INA 212(g) holds that the numerical limitation only apply to those who are being “provided” H-1B status, not to those already in such status and seeking its extension.

Therefore, it is my belief that a physician who is finishing a residency or fellowship and going into private practice (not cap exempt) MAY apply for a change in previously approved employment so long as the physician applies for an extension of his H-1B from within the US (not through consular processing). Of course, this strategy alone can be unreliable and can often result in a gap in status. It is often the case that a physician whose H-1B expires on June 30 and is approved for an H1B with a new employer (subject to the cap) on October 1 finds that he is suddenly without status for the period June 30 to October 1. In such cases, aliens should consider changing their status to H-4 or to B-2 in order to prepare and take the Board exams. In addition, it would be wise to extend an exempt H-1B to cover the July to October gap. Foreign nationals should be aware that a temporary extension with the H-1B exempt employer is possible even where the physician will provide services a few hours per week. Otherwise, physicians who are not able to pursue the above options may be forced to leave the country until they can return in H1B status on October 1.

Another excellent option to avoid the “cap gap” problem is the NIW/HPSA immigration strategy. An NIW/HPSA is an immigrant petition in which the alien agrees to serve as a primary care physician (unless employer is a VA) for a five-year period in an underserved area. The benefit of such an application is that the alien may be able to file an I-485 adjustment of status immediately and work authorization (as long as such is not prohibited by retrogression in the EB-2 category). This allows the applicant and his or her derivative family members to receive employment and travel authorization for the duration of the pending application and it prevents the alien from falling out of status. In addition, many foreign nationals fear this type of application because they do not want to commit to one employer for such a long period of time. However, the terms of employment can allow the five year contract to terminate at will or by giving due notice. The alien may not indeed actually need to complete the five year commitment either. This strategy can be supplemented by an independent immigration strategy such as a labor certification or a self sponsored EB-1 which if successful would allow immigration to complete in a shorter time period.

In many circumstances, physicians may pursue other avenues such as the O-1 or EB1/NIW petitions.

Although navigating through the transfer process is a meticulous one when the H-1B cap is an issue, physicians may gain comfort in the fact that options and relief are available to their unique challenges.

Vitamin D: Can it Really Keep You Cancer Free?

Once only associated with strong bones and teeth, new scientific research is finding that Vitamin D can cut your risk of developing common cancers by as much as 50%.

Says Sara Hiom, head of health information at Cancer Research UK, “There is evidence to suggest that the vitamin (Vitamin D) plays a role in keeping cells healthy.”

Researchers in the U.S. have found that the “natural” form of Vitamin D, D3 or cholecalciferol, can dramatically cut our chances of getting breast, ovarian, colon, and prostate cancers by up to 50%.

As a matter of fact, researchers are telling us that they have known about the link between Vitamin D and a decreased cancer risk for years.

Well my question to them is this… what has been taking you so long to tell us?

They say that up until just recently, they did not know the levels of Vitamin D necessary to provide this decreased risk.

What current research is now finding is that the optimum amount of Vitamin D necessary to reduce your risk of developing these cancers is 1000 IU. This is two and a half times the Recommended Daily Allowance of 400 IU set forth by the Food and Nutrition Board of the Institute of Medicine here in the U.S.

Many experts now believe that the current RDA of 400 IU for an adult is too low and does nothing more than help ward off chronic bone diseases such as rickets and osteoporosis.

Recently, an article appearing in the American Journal of Public Health, after reviewing 63 independent studies, concluded that thousands of lives might be saved each year and thousands more cancers prevented by folks taking supplemental Vitamin D.

Professor Cedric Garland of the University of California in San Diego who led a major study on the relationship between Vitamin D and cancer risk said this, “A preponderance of evidence, from the best observational studies the medical world has to offer has led to the conclusion that public health action is needed.”

This public health action he advocates is the education of the public concerning Vitamin D.

What form of Vitamin D is Best?

Remember that your body has the ability to manufacture its own Vitamin D through direct exposure to sunlight. This form of Vitamin D is called Vitamin D3 or cholecalciferol. This of course is the best form of the vitamin.

The synthetic form is Vitamin D2 or ergocalciferol. This is what is used to fortify milk for instance. It is estimated that it takes twice as much D2 to get the same benefit as Vitamin D3.

Vitamin D3 can also be found in oily fish such as salmon (3 ounces = 530 IU), sardines (3 ounces = 231 IU), and Mackerel (3 ounces = 214 IU).

Unfortunately not all of us can get the required amount of sunlight necessary to produce enough Vitamin D3.

Some of us have fair skin and need to use sunscreen when we venture outdoors. Some of us have dark skin and do not produce as much Vitamin D3 due to our skin pigment.

And of course, the cold parts of the year can keep most of us indoors or bundled up when we do head outside.

And also unless you eat lots of oily fish, you are not going to get your 1000 IU there either.

Professor Garland warned about the dangers of overexposure to the sun, “Dark-skinned people, however, may need more exposure to produce adequate amounts of vitamin D, and some fair-skinned people shouldn’t try to get any vitamin D from the sun. The easiest and most reliable way of getting the appropriate amount (of Vitamin D) is from food and a daily supplement.”