INTERVIEWEE - Dr. Heather Eade, ND,
Naturopathic Physician, Integrative Medicine Specialist
Get Enough Vitamins; Beat Infections Naturally
It is not necessary to take multivitamins or supplements to stay healthy as long as we are getting all the nutrients we need from our diet. However, some recent studies in the United Arab Emirates show that majority of its population suffer from Vitamin D and B12 deficiencies. Nutrient deficiencies occur when we don’t get enough vitamins and minerals over a long period of time. But it is difficult to know what our body needs and when without the guidance of a medical practitioner. Dhanya AK reaches out to Dr. Heather Eade, ND, naturopathic physician, integrative medicine specialist, Novomed Integrative Medicine, Dubai, UAE, and gets expert advice for our readers on the symptoms, causes and treatment of the vitamin deficiencies. Along with that, prevention of antibiotic resistance, which is at alarming levels in the region, is explained.
Vitamin D Deficiency
Vitamin D, also known as the ‘Sunshine Vitamin’, is produced by the body in response to sun exposure; it can also be consumed in fortified foods or supplements. Vitamin D is an extremely important vitamin that has powerful effects on several organ systems throughout the body. Vitamin D deficiency can harm the overall health of a person.
Last year, a study in Dubai showed an estimated 90% of the UAE’s population is Vitamin D deficient. Is there any particular reason for this condition in a sunny country like the UAE?
We get Vitamin D mainly from exposure to sunlight. The main reason for Vitamin D deficiency is inadequate sun exposure. In order to maintain healthy levels of Vitamin D, we all need at least 20 minutes of exposure per day on face, arms and legs. But the problem is we are covered in clothes when we expose ourselves to the sun, or we are wearing sunscreen. The other challenge is we cannot have more than twenty minutes of unprotected sun exposure without damaging our skin. Furthermore, when we go out, we use cosmetics and sunscreen lotions which contain high levels of SPF. Consequently, we are missing the benefit of sun exposure. The other area is absorption. Different ethnic backgrounds have different levels of absorption. People’s DNA background can influence their ability to absorb Vitamin D efficiently.
Which are the ideal times of a day when people should expose themselves to the sun to enable their body to produce vitamin D?
The ideal time is when the sun is at its highest point. But we need to protect our skin as well. Don’t stay exposed to the sunlight without protection longer than twenty minutes.
Have any changes been applied in measuring the deficiency which was not predominant here earlier?
One of the arguments as to why it’s a ‘new’ phenomenon is that we just didn’t measure it as frequently before. Another argument is we didn’t understand the broader importance of Vitamin D earlier. We used to think Vitamin D was related to bone density and calcium deficiency alone. But now we know that Vitamin D is essential for prevention of diseases like cancer, diabetes, and heart disease. A certain level of Vitamin D is available in our blood. But that level actually should be higher to prevent cancer, diabetes and heart diseases. We are seeing higher deficiency rate nowadays because we have raised the bar of vitamin D levels in terms of prevention of diseases like cancer. Meanwhile, some people say that the difference is with sun exposure. They argue that earlier we used to spend more time outside getting enough sunlight. Research has shown that there has been a reduction in our levels of sun exposure over the last several hundred years.
What are the consequences of Vitamin D deficiency?
The long-term consequences are heart disease, diabetes and cancer. They are our biggest killers now. In an overall sense, I recommend vitamin D supplementation consistently, because Vitamin D is necessary for disease prevention.
What are the dangers of Vitamin D deficiency in pregnant women and infants?
We need Vitamin D for bone growth. During pregnancy, a baby’s bones and connective tissue are developing. All these are reliant on its mother’s Vitamin D levels. Women who are trying to conceive should check their Vitamin D levels prior to conception.
How can people boost their Vitamin D level through a good diet?
Some foods like milk and cereals are fortified with Vitamin D, but that still might not be enough to raise blood levels to ideal range. Meat/poultry naturally contain small amounts of Vitamin D. The best way we can get Vitamin D naturally is from sufficient sun exposure. We should follow a healthy active lifestyle outdoors with some supplementation. Usually I recommend three-months supplementation course, then checking blood levels with your doctor. Optimal range for vitamin D levels in the blood is 50-80 ng/mL.
Are vegans at a higher risk of lacking vitamin D because they avoid dairy products?
Vitamin D is naturally found in meats/poultry. Dairy products are usually fortified. It may be the case that vegans are more prone to Vitamin D deficiency. But vegan foods like cereals are fortified with Vitamin D, so they can get some Vitamin D intake from those foods.
Vitamin B12 Deficiency
Vitamin B12 is a crucial B-Vitamin. It is needed for nerve tissue health, brain function, and the production of red blood cells. It is also involved in the formation of red blood cells and helps to build and regulate DNA. Cobalamin is another name for Vitamin B12. Deficiency of Vitamin B12 can lead to neurological difficulties and anemia.
Is Vitamin B12 deficiency also becoming prevalent in the region? How can we rectify this?
Vitamin B12 is found in meats and eggs. If we are not taking these foods on a regular basis, we are at a risk of becoming Vitamin B12 deficient. Another reason some people become deficient is inadequate stomach acid levels; stomach acid is required to liberate Vitamin B12 from food. This can also be caused by a lack of intrinsic factor, a protein produced by the cells that line the stomach, which leads to a condition called pernicious anemia — these people cannot absorb Vitamin B12.
However, Vitamin B12 is easy to supplement and people’s levels come up quickly. The real key about taking Vitamin B12 orally is that it should be something that you suck on or take sublingually rather than a pill you swallow. Some people respond well to injections. I favour oral sublingual supplementation over injections as it provides a more consistent delivery to the bloodstream.
Any healthy person who is a vegan or a vegetarian can get vitamin B12 deficient as he/she does not eat enough eggs or dairy products to meet the body’s vitamin B12 needs. Is this statement true?
Yes. Mainly for vegans, because they don’t eat eggs or dairy products.
What supplementary foods can general people of all age groups, vegetarians and vegans take to maintain the vitamin B12 levels?
The best sources are animal-derived foods. Plant based sources are minimal.
Are nutritional supplements and vitamins safe and effective?
In general, it’s safe although there are many precautions. Following clear dosing parameters for dosing the supplements is essential, as well as understanding clinical indications and contra-indications. Typically, I don’t recommend vitamin supplements for people unless I know they are deficient. The real challenge is walking into a pharmacy and getting supplements without proper medical guidance. It’s risky.
How to choose good supplements?
We want manufacturers who follow Good Manufacturing Practices (GMP). This is a standardised set of steps designed to ensure quality and standardisation of dosage. They should be able to provide consumers with evidence that they are following these practices. Good brands always get their products third-party assessed and follow GMP guidelines, and will post this information on their websites. Typically with supplements, we get what we pay for. More expensive usually (but not always) means better quality. The best way to ensure that you are getting good quality and appropriate, clincally proven dosing is to consult someone with the qualifications and license to recommend supplements.
How often we should check our body’s key nutritional levels so that any imbalances can be dealt with via the proper course of treatment?
A person ideally should do that at least once in a year. For people with health problems, frequent screening is recommended. But a basic healthy diet is of primary importance.
This phenomenon occurs when bacteria evolve and become resistant to the use of antibiotics. These bacteria then infect humans and are much more difficult, even impossible, to destroy as they are not as responsive to antibiotics.
In the UAE, antibiotic resistance has already reached a ‘very concerning high level’ as per some studies. What is the solution to this issue?
Antibiotic resistance is becoming more prevalent and a more pressing clinical problem, especially in potentially fatal infections. One problem is that we still don’t have any new antibiotics to fight these resistant bacteria, although this is a current area of research. Until then, the bacteria will win the fight. In the meantime, unless we start prescribing less antibiotics, this is unlikely to change. Aside from that, the balance of beneficial bacteria in our gut is critical to helping us fight infection. Poor gut flora regulation has been linked to obesity, skin problems and hormone changes. This is also an emerging important area of research. The most important thing we can do is prescribe antibiotics only as a last resort. We should not just walk into a pharmacy and grab antibiotics when we don’t know if they are indicated. Often viral infections are mistakenly treated with antibiotics this way, increasing the likelihood of antibiotic resistance. People need to understand that it’s OK to get a fever and feel ill — that is how our immune system fights infection. Taking antibiotics at the first sign of cold/flu can be a terrible mistake.
I always suggest that people maintain the habits of a healthy lifestyle, which are healthy diet, hydration, exercise and sleep. If someone gets sick every month and needs to take antibiotics, that person has a problem with lifestyle, and lifestyle factors need to be addressed in their treatment plan.
Dr. Heather Eade is a Canadian Board-certified naturopathic physician and integrative medicine specialist. She graduated from the Boucher Institute of Naturopathic Medicine in Vancouver, BC, Canada, which is one of only nine CNME-approved medical schools in North America. An active member of the College of Naturopathic Physicians of British Columbia, the British Columbia Naturopathic Association, and the Canadian Association of Naturopathic Doctors, Dr. Heather has additional certifications in acupuncture and IV/chelation therapy.
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