Experts recommend daily doses of vitamin D

Q. As a physician, I have been testing my patients for 25-hydroxy vitamin D for several months. Many are deficient, and some have symptoms of pain and muscle weakness.

I advise patients to take one or two vitamin D supplements of 1,000 units daily. Many pharmacists are not aware of the new information, and some have discouraged my patients from buying such supplements if they are taking multivitamins with 400 International Units per daily dose. Please write about this issue.

A. Fatigue, high blood pressure and joint and muscle pain are just a few of the possible symptoms associated with vitamin D deficiency. Researchers are reporting high rates of this condition because few people spend much time outside, especially during the winter. During the summer, conscientious use of sunscreen can block vitamin D formation.

Experts are now recommending daily doses of vitamin D in the 1,000 to 2,000 range. Although pharmacists may worry about the potential for vitamin D toxicity, this appears to occur only at much higher doses.

Q. I have heard that an ingredient in plastic called bisphenol A can get into foods and beverages from containers. I was so impressed with the evidence of harm that I thought I would see what food I could buy without plastic wrap, plastic containers or cans.

My options were few! I bought a lot of fresh veggies, but had to put them in plastic bags. We don’t drink sodas, but many “healthy” drinks come in plastic. I searched for glass-bottled juices and oils but found very few choices. The meats, eggs, “smart” margarines – even the organic versions – all came in plastic containers, and were often wrapped in plastic.

My shopping cart was full of interesting new choices, but I wonder: How can I avoid plastics with bisphenol A?

A. There is a raging controversy about the safety of bisphenol A found in polycarbonate plastics. This compound mimics estrogen. Water bottles, baby bottles and the lining of metal cans often contain BPA. Plastic containers may be marked with the recycling code “7.”

On our radio show, we discussed the health consequences of BPA in great detail with some of the country’s leading experts. Anyone who would like this one-hour CD on Sex Hormone Disruption may send $16 to: Graedons’ People’s Pharmacy (CD-670), P.O. Box 52027, Durham, NC 27717-2027. Show No. 670 is also available at www.peoplespharmacy.com.

Q. I have read that using decongestant nasal sprays can be addictive. What are your views on using oral OTC cold remedies for more than seven days? Will these cause any symptoms when I stop?

A. There is considerable controversy about the effectiveness of the readily available oral decongestant phenylephrine (Annals of Pharmacotherapy, March 2007). Such drugs seem less likely to cause rebound nasal congestion, but they may raise blood pressure in susceptible individuals. Since there is doubt about their benefit, we generally don’t recommend them.

Q. I was diagnosed with celiac disease and advised to avoid gluten from wheat, rye and barley. Avoiding gluten in my diet has made a huge difference for me. Are there any resources to help me avoid gluten in pills?

A. In celiac disease, ingesting gluten triggers the immune system to attack the body, especially the small intestine. This interferes with nutrient absorption. The Food and Drug Administration does not require manufacturers to list gluten on drug labels, but you can look up your medicines at www.glutenfreedrugs.com.