Vitamin D

Why do I need vitamin D?

Vitamins are substances that your body needs to grow and develop normally. Vitamin D is important to your body because:

• It helps your body absorb calcium. Calcium is one of the main building blocks of bone. A lack of vitamin D can lead to bone diseases such as osteoporosis or rickets.
• It also has a role in your nerve, muscle, and immune systems:
  • Your muscles need it to move
  • Your nerves need it to carry messages between your brain and your body
  • Your immune system needs vitamin D to fight off bacteria and viruses

You can get vitamin D in three ways: through your skin, from your diet, and from supplements. Your body forms vitamin D naturally after exposure to sunlight. However, too much sun exposure can lead to skin aging and skin cancer. So many people try to get their vitamin D from other sources.

Very few foods naturally contain vitamin D. Most people get vitamin D in their diet from foods that are fortified. This means that vitamin D is added to the food. These foods may include milk, cereal, and yogurt. Foods that naturally have vitamin D include egg yolks, saltwater fish, and liver.

Vitamin D is available in supplements. It is also included in many multivitamins. The two forms of vitamin D in supplements are D2 and D3. Both types increase vitamin D in your blood, but D3 might raise it higher and for longer than D2. Vitamin D is fat soluble. You can absorb it better when you take your supplements with a meal or snack that includes some fat.

The amount of vitamin D you need each day depends on your age. The recommended amounts, in international units (IU), are:

• Birth to 12 months: 400 IU
• Children 1-13 years: 600 IU
• Teens 14-18 years: 600 IU
• Adults 19-70 years: 600 IU
• Adults 71 years and older: 800 IU
• If you are pregnant or breastfeeding: 600 IU

But certain people may need extra vitamin D, such as:

• Older adults
• Breastfed infants
• People with dark skin
• People with certain conditions that limit the absorption of fat, such as Crohn's disease, celiac disease, and ulcerative colitis
• People who have obesity or have had gastric bypass surgery

Check with your health care provider to see if you need to take vitamin D supplements, and if so, how much you should take. Your provider may want to first do a vitamin D test to see if you are getting enough of it.

NIH: National Institutes of Health Office of Dietary Supplements

Weight Control

Why is weight control important?

If you are struggling with your weight, you are not alone. In the United States, more than 70 percent of adults are overweight or have obesity. Having this extra weight raises your risk for many health conditions, such as type 2 diabetes, heart disease, kidney disease, and certain cancers.

Reaching and staying at a healthy weight can be challenging. But having a healthy lifestyle, including healthy eating patterns and regular physical activity, can help you lose weight. It can also lower your chance of developing weight-related health conditions.

You gain weight when you take in more calories (through food and drinks) than you use up from physical activity and daily living. But there are many different factors that can affect weight gain, such as:

• The world around you. Your home, community, and workplace all may affect how you make daily lifestyle choices. For example:
  • It is often easier to find food and beverages high in calories, sugar, and fat. For instance, vending machines, cafeterias, and special events may not offer healthy, lower calorie options.
  • Less healthy foods may be cheaper than healthier foods.
  • Many people are getting less physical activity because they are spending more time using smartphones and other devices.
• Families. Overweight and obesity tend to run in families. This suggests that genes may play a role in weight gain. Families may also share eating and lifestyle habits. For example, some families may often have foods and drinks that are high in calories, sugar, and fat. And some families may tend to be less active and spend more time doing things like sitting and watching TV or using computers.
• Not enough sleep. People who don't get enough sleep may eat more calories and snack more.
• Emotions. Some people eat when they feel bored, sad, or stressed, even if they are not hungry.
• Medicines and health conditions. Taking certain medicines, such as steroids and certain antidepressants, can lead to weight gain. Some chronic health problems can also cause you to gain weight. A few examples are Cushing's syndrome and polycystic ovary syndrome (PCOS).

Getting to and staying at a healthy weight involves finding a balance of food and activity. To lose weight, you need to take in fewer calories than you use up. Some ways to do this are:

• Eating more nutrient-rich foods, such as foods with lots of vitamins, minerals, and fiber.
• Eating and drinking less of the foods and beverages that have lots of calories, salt, sugar, and fat.
• Limiting alcohol.
• Finding healthier ways to cook, such as using healthier oils to cook with and baking or grilling instead of frying foods.
• Getting more physical activity. The general recommendation is for adults to get 150 minutes of physical activity each week. This time can be broken down into short bursts of activity throughout your day. Types of physical activity include:
  • Aerobic activity, which is also called cardio. It uses your large muscle groups (chest, legs, and back) to speed up your heart rate and breathing.
  • Muscle-strengthening activity, which is also called strength training. It works your muscles by making you push or pull against something.

You may decide to do these lifestyle changes on your own, or you may decide to try a weight-loss diet or program. Before you start, it's important to check with your health care provider first. Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight.

If making lifestyle changes or doing a weight-loss program are not enough to help you lose weight, your provider may prescribe medicines. These medicines are meant to help people who have weight-related health conditions and should be used along with healthy eating and physical activity. The prescription medicines to treat overweight and obesity work in different ways. Some may help you feel less hungry or full sooner. Others may make it harder for your body to absorb fat from the foods you eat.

Another treatment is weight loss surgery. Your provider may recommend the surgery if you have severe obesity or serious obesity-related health problems and you have not been able to lose enough weight.

Maintaining weight loss can be challenging, and it's normal to slip back into old habits sometimes. The key is to keep a healthy balance of food and activity that works for you. Checking your weight regularly can help you notice small changes early and stay on track. And if you have a setback, don't be discouraged, simply refocus on your healthy habits and keep going.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

X-Rays

What is an x-ray?

X-rays are a painless medical imaging test. They send a small amount of radiation through your body to create pictures of bones and organs.

X-rays are a type of electromagnetic radiation. They create images in shades of black, white, and gray because different tissues absorb radiation differently. Bones absorb the most radiation and appear white. Fat and other soft tissues absorb less and appear gray. Air absorbs the least radiation, so areas like the lungs appear black.

The image is recorded on film or sent to a computer. Health care providers use x-rays to find health problems and to check how well certain treatments are working.

X-rays are commonly used to check for fractures (broken bones). They are also used for other purposes. For example, chest x-rays can detect pneumonia. Mammograms use x-rays to look for breast cancer. X-rays are also used as part of other imaging tests, such as CT scans.

In most cases, little or no preparation is needed. You may be asked to wear a lead apron to protect certain parts of your body. You may also be asked to remove jewelry or other items that could affect the image.

The amount of radiation from an x-ray is small. For example, the radiation from a chest x-ray is about the same as the natural radiation you are exposed to from the environment over about 10 days.

Always tell your provider if you are pregnant or think you may be pregnant.

Depending on the part of your body being examined, you may be asked to stand, sit, or lie down. You will need to stay still for a short time while the image is taken.

After an x-ray, you can return to normal activities right away. A specialist called a radiologist reviews the images and shares the results with your provider.

Addison Disease

Your adrenal glands are just above your kidneys. The outside layer of these glands makes hormones that help your body respond to stress and regulate your blood pressure and water and salt balance. Addison disease happens if the adrenal glands don't make enough of these hormones.

A problem with your immune system usually causes Addison disease. The immune system mistakenly attacks your own tissues, damaging your adrenal glands. Other causes include infections and cancer.

Symptoms include:

• Weight loss
• Muscle weakness
• Fatigue that gets worse over time
• Low blood pressure
• Patchy or dark skin

Lab tests can confirm that you have Addison disease. If you don't treat it, it can be fatal. You will need to take hormone pills for the rest of your life. If you have Addison disease, you should carry an emergency ID. It should say that you have the disease, list your medicines and say how much you need in an emergency.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Advance Directives

What kind of medical care would you want if you were too ill or hurt to express your wishes? Advance directives are legal documents that allow you to spell out your decisions about end-of-life care ahead of time. They give you a way to tell your wishes to family, friends, and health care professionals and to avoid confusion later on.

A living will tells which treatments you want if you are dying or permanently unconscious. You can accept or refuse medical care. You might want to include instructions on:

• The use of dialysis and breathing machines
• If you want to be resuscitated if your breathing or heartbeat stops
• Tube feeding
• Organ or tissue donation

A durable power of attorney for health care is a document that names your health care proxy. Your proxy is someone you trust to make health decisions for you if you are unable to do so.

NIH: National Cancer Institute