6 things you should know about vitamin D

Figuring out all the factors that can affect your vitamin D level is complicated. Your body makes vitamin D when sunlight hits the skin. You can also get the vitamin from food (mainly because it's been added; few foods are natural sources of vitamin D) or by taking a supplement.

The process by which the body makes vitamin D is complex. It starts when the skin absorbs rays in the invisible ultraviolet B (UVB) part of the light spectrum. The liver and the kidneys also participate to make a form of the vitamin that the body can use.

A number of factors influence a person's vitamin D levels. Here are six important ones.

Where you live. The further away from the Equator you live, the less vitamin D–producing UVB light reaches the earth's surface during the winter. Residents of Boston, for example, make little if any of the vitamin from November through February. Short days and clothing that covers legs and arms also limit UVB exposure.

Air quality. Carbon particles in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays, diminishing vitamin D production. In contrast, ozone absorbs UVB radiation, so pollution-caused holes in the ozone layer could end up enhancing vitamin D levels.

Use of sunscreen. Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen's effects on vitamin D might not be that important. An Australian study that's often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.

Skin color. Melanin is the substance in skin that makes it dark. It "competes" for UVB with the substance in the skin that kick-starts the body's vitamin D production. As a result, dark-skinned people tend to require more UVB exposure than light-skinned people to generate the same amount of vitamin D.

Weight. Body fat sops up vitamin D, so it's been proposed that it might provide a vitamin D rainy-day fund: a source of the vitamin when intake is low or production is reduced. But studies have also shown that being obese is correlated with low vitamin D levels and that being overweight may affect the bioavailability of vitamin D.

Age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor. There's also experimental evidence that older people are less efficient vitamin D producers than younger people.

Two keys to strong bones: Calcium and Vitamin D

Although bone-weakening osteoporosis is quite common among older people, it isn't an inevitable part of aging. There's a lot you can do to shield your bones from this disease.

The best insurance against osteoporosis is building the highest bone density possible by your 30s and minimizing bone loss after that. But if you're already in midlife or beyond, there is still much you can do to preserve the bone you have and perhaps even to replace lost bone. Daily weight-bearing exercise, like walking, is the best medicine. Getting enough calcium and vitamin D are two other critical strategies for keeping bones strong.

Calcium

Calcium is an important nutrient for building bone and slowing the pace of bone loss. But it's not a single magic bullet, and some scientists suggest that too much calcium or dairy products may be unhealthy. Keep in mind that in addition to calcium, there are other nutrients and foods that help keep your bones strong — most importantly vitamin D, but also vitamin K.

How much calcium? The recommended daily intake for calcium is 1,000 milligrams (mg) a day for adults up through age 50 and 1,200 mg a day for people ages 51 and older, when bone loss accelerates. With age, the intestines absorb less calcium from the diet, and the kidneys seem to be less efficient at conserving calcium. As a result, your body can steal calcium from bone for a variety of important metabolic functions.

Because some research suggest that high calcium intake may increase the risk of prostate cancer, men should avoid taking calcium supplements or taking too many calcium-rich antacids.

Vitamin D

In building bone, calcium has an indispensable assistant: vitamin D. This vitamin helps the body absorb calcium, and some researchers think that increasing vitamin D can help prevent osteoporosis. Milk sold in the United States is fortified with vitamin D. Vitamin D is also prevalent in fortified breakfast cereals, eggs, and vitamin supplements. Some brands of yogurt are fortified with it, as well as some juices.

If possible, a small amount of sun exposure can help your body manufacture its own vitamin D — about five to 30 minutes of sunlight between 10 a.m. and 3 p.m. twice a week to your face, arms, legs, or back without sunscreen will enable you to make enough of the vitamin. People with fair skin that burns easily should protect themselves from skin cancer by limiting sun exposure to 10 minutes or less.

Food and sun exposure should suffice, but if not, some experts advise getting 1,000 IU of vitamin D daily from a supplement.

How medications can affect your balance

Medications make a difference — generally a positive one — in the lives of many people. But at the same time, all drugs carry side effects — and with many medications, one or more of those side effects can alter your balance. How? According to the Centers for Disease Control and Prevention, common problems include vision changes, dizziness or lightheadedness, drowsiness, and impaired alertness or judgment. Some medications can even damage the inner ear, spurring temporary or permanent balance disorders.

Some of the commonly prescribed medications that can affect balance include:

antidepressants

anti-anxiety drugs

antihistamines prescribed to relieve allergy symptoms

blood pressure and other heart medications

pain relievers, both prescription and non-prescription

sleep aids (over-the-counter and prescription forms)

Sometimes the problem isn't a single drug, but a combination of medications being taken together. Older adults are especially vulnerable because drugs are absorbed and broken down differently as people age.

If you are concerned about how your medications may be affecting your balance, call your doctor and ask to review the drugs you're taking, their doses, and when you take them. It is never a good idea to just stop taking a medication without consulting your doctor first.

Women and sleep: 5 simple steps to a better night's rest

Sleep shortfalls can lead to a range of health problems, from being more likely to catch a cold or gain weight to increased risk of developing heart disease or diabetes.

For optimum health and function, the average adult should get seven to nine hours of sleep every night. But more than 60% of women regularly fall short of that goal.

This may be due to insomnia or another underlying condition that may require medical attention. But most women with a sleep debt run it up by burning the candle at both ends — consistently failing to get to bed on time or stay there long enough.

Don't worry about repaying the old sleep debt. Just make sure you start getting enough sleep from this point forward — starting tonight. Getting enough sleep is just as important as eating a healthy diet and getting regular exercise.

Tips for getting the rest you need:

Create a sleep sanctuary. Reserve your bedroom for sleep and intimacy. Keep it on the cool side. Banish the television, computer, smartphone or tablet, and other diversions from that space.

Nap only if necessary. Taking a nap at the peak of sleepiness in the afternoon can help to supplement hours missed at night. But naps can also interfere with your ability to sleep at night and throw your sleep schedule into disarray. If you need to nap, limit it to 20 to 30 minutes.

Avoid caffeine after noon, and go light on alcohol. Caffeine can stay in your body for up to 12 hours. Alcohol can act as a sedative, but it also disturbs sleep.

Get regular exercise, but not within three hours of bedtime. Exercise acts as a short-term stimulant.

Avoid backsliding into a new debt cycle. Try to go to bed and get up at the same time every day — at the very least, on weekdays. If need be, use weekends to make up for lost sleep.

Is it just midlife, or is your thyroid slowing down?

Maybe you're feeling tired and having trouble concentrating — or perhaps you've noticed changes in your hair or weight, or just feel blah. You might easily attribute these issues to other health problems, or to simply getting older. But these symptoms can be signs of a sluggish thyroid.

The thyroid is a butterfly-shaped gland in the neck. It produces the hormones that regulate metabolism. Low levels of thyroid hormone can cause a range of symptoms, including fatigue, constipation, dry skin, brittle nails, hair changes, aches and pains, and feeling down. Untreated, an underactive thyroid (hypothyroidism) can increase the chances of developing high cholesterol, high blood pressure, and heart disease.

Women are more likely than men to have problems with their thyroid, particularly as they get older. In some women, the onset of thyroid trouble is so gradual that it's hardly noticeable; in others, symptoms come on abruptly over the course of a few weeks or months. These include:

Fatigue. You may feel unusually tired and have less energy.

Cold intolerance. You may feel chilly even when others around you are comfortable.

Appetite loss, weight gain. When metabolism is dragging, you need fewer calories so your appetite may decrease — at the same time, you are using fewer of the calories you do eat, so more are stored as fat.

Cardiovascular effects. Low levels of thyroid hormone can lead to high blood pressure as well as elevated levels of total and LDL cholesterol. Over time, an underactive thyroid can compromise the ability of the heart to pump blood effectively.

Mental effects. Hypothyroidism and depression share many of the same symptoms, including trouble concentrating, memory problems, and loss of interest in things that are normally important to you.

Other signs and symptoms. Hypothyroidism can cause symptoms throughout the body, from constipation to muscle aches and pain around the joints. Skin, hair, and nails may become dry and thin.

If you have any of these symptoms, see your doctor. She or he will examine you for signs of hypothyroidism, and may recommend blood tests to check thyroid function.

Hypothyroidism is usually treated with a daily dose of synthetic thyroid hormone, which is taken as a pill. This medication works exactly like your body's natural thyroid hormone. It may take some time to find the right dose for you. Once you do, symptoms usually improve dramatically. Your doctor will check your thyroid function usually once or twice a year to be sure that your dose of medication remains optimal.

Hope for treatment of migraine

This throbbing headache can last for hours or even days. Although it affects more than 36 million Americans between the ages of 15 and 55, the exact cause of migraines is still largely unknown.
What is a migraine?
Migraines are different than regular headaches. Headaches can cause mild to severe pressure and aching on both sides of your head, and they can last anywhere from 30 minutes to a week. “A normal headache feels like someone put a belt around your head and is pressing on it,” says Dr. Carolyn Bernstein, a neurologist at Brigham and Women’s Hospital and assistant professor of neurology at Harvard Medical School. “You can usually work through it but they’re pretty annoying.”
The three most common types of headaches are: sinus headaches, cluster headaches, and tension headaches. Of these, tension headaches are the most common and are typically caused by stress, muscle strain, or anxiety.
On the other hand, a migraine is a recurrent, throbbing headache that often affects only one side of the head. In addition to pain behind the eyes or ears, migraines can cause nausea and vomiting, vision problems, and sensitivity to sounds and lights. Experts don’t know precisely what causes migraine, although some migraine sufferers can point to certain things that seem to trigger their migraines. “Family history is a big factor, but people have different sensitivities to different triggers,” says Bernstein. These other triggers can include age, sex, hormonal changes, food, alcohol, and poor sleep.

Migraines and light sensitivity
One of the most common symptoms of a migraine is an increased sensitivity to light, called migraine photophobia. This can be so pronounced that migraine sufferers often need total darkness to deal with the pain.
But a recent study published in the journal Brain: A Journal of Neurology suggests that certain colors of light might not be all bad. Researchers found that while migraine headaches are exacerbated by light in general, green light in particular might not be as disruptive as previously thought.
Throughout the study, researchers flashed different colors of light at people suffering from migraines to test changes in migraine intensity, pain rating, sensory perception, and the spread of the migraine from the original site.
Compared to red, blue, and white lights, green light reduced migraine intensity in more than 20% of patients. It was the only light that reduced pain intensity, while white, blue, and red significantly increased pain ratings and muscle tenderness. Finally, more patients described the migraine spreading beyond its point of origin when they were exposed to blue, amber, and red light compared to white and green light. “The green light was easier for people to tolerate, and some people even felt better after seeing it,” says Bernstein, who led the clinical side of the study. “Not everyone had the same response, but overall there were enough data to show green light was preferred.”
Although green light didn’t do anything to cure the headache, this study does open the door for more research and potential therapies using green light down the road.
How do we treat migraine headaches now?
Right now, green light might not be a viable migraine therapy. For now, medications that treat the symptoms of migraines, including pain and nausea, offer some relief.
However, physicians advise that the best option for treating a migraine is preventing one from occurring in the first place. Avoiding triggers, managing stress, and getting enough sleep are just a few of the steps people can take. But doctors advise that no one should suffer from migraines silently.
“People need to understand that there is treatment for acute migraines,” says Bernstein. “If they are impacting your life it is important to see someone who can specifically treat them.”

Caregiving!!!!

Caring for a person with dementia or Alzheimer's disease presents a range of challenges. Spouses, family members, and friends must deal with feelings of loss as the person they know seems to slip away. Supporting a loved one with basic activities of daily living can be time consuming and exhausting. And it is difficult to balance protecting the person you're caring for and preserving what independence remains.

One of the trickiest problems to negotiate is driving. The consequences of a misstep behind the wheel can be deadly.

Get your copy of Alzheimer's disease

Have you noticed memory problems piling up in ways that affect daily life in yourself or someone you love? Do you find yourself struggling to follow a conversation or find the right word, becoming confused in new places, or botching tasks that once came easily? About 5.4 million Americans have Alzheimer’s disease, and estimates suggest it will affect 7.7 million by 2030. Already, it is the sixth leading cause of death in the United States. This Special Health Report includes in-depth information on diagnosing Alzheimer’s and treating its symptoms.

Decisions about driving

Whether or not it is safe to drive can be complicated, particularly when the person is only mildly impaired. Some believe that driving privileges should not be taken away until a person is clearly an unsafe driver.

But can you identify an unsafe driver before an accident occurs?

Driving requires amazing coordination — the eyes, brain, and muscles must process information and respond to it quickly. Driving skills may seem sufficient until an unexpected situation occurs when a person with dementia can panic or freeze with indecision. A University of California study found that the driving skills of people with mild Alzheimer's were significantly poorer than those of other elderly people, including those with some other forms of dementia.

One way to gauge the risk is to observe the person's general behavior. If friends and family see their loved one exhibit poor judgment, inattentiveness to what's going on around him or her, clumsiness, and slow or inappropriate reactions, then that person should not get behind the wheel.

Taking away the keys

Ideally, a tactful and respectful approach will preserve the person's self-esteem while getting them off the road. Some people may agree to stop driving for other reasons — for instance, the car needs repair or the license or registration has expired. You can also opt for a road test with a driver's rehabilitation specialist, who can offer an independent assessment of safety. People with Alzheimer's disease sometimes take seriously a written prescription from a physician that says, "Do not drive."

In some states, doctors have a legal duty to report unsafe drivers and drivers with certain medical problems to the state department of motor vehicles. If all else fails, you may need to seek advice from a lawyer or an official with the Department of Public Safety in your state. Procedures vary, but generally a driver's license can be suspended on the basis of a physician's written statement.

5 truths about protecting your eyes

Of your five senses, which one are you most afraid of losing? If you're like most people, your answer is your ability to see. Because our eyesight is so precious, it's no wonder that myths abound about what can damage our eyes — and what can protect them. Here, we debunk five common myths — and tell you how to truly keep your eyes healthy.

Myth: Doing eye exercises will delay the need for glasses.

Fact: Eye exercises will not improve or preserve vision or reduce the need for glasses. Your vision depends on many factors, including the shape of your eyeball and the health of the eye tissues, neither of which can be significantly altered with eye exercises.

 When the eyes age, problems with vision become more common. Learn how to recognize the risk factors and symptoms of specific eye diseases — cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy — and what steps you can take to prevent or treat them before your vision deteriorates.

Myth: Reading in dim light will worsen your vision.

Fact: Dim lighting will not damage your eyesight. However, it will tire your eyes out more quickly. The best way to position a reading light is to have it shine directly onto the page, not over your shoulder. A desk lamp with an opaque shade pointing directly at the reading material is ideal.

Myth: Carrots are the best food for the eyes.

Fact: Carrots, which contain vitamin A, are indeed good for the eyes. But fresh fruits and dark green leafy vegetables, which contain more antioxidant vitamins such as C and E, are even better. Antioxidants may even help protect the eyes against cataracts and age-related macular degeneration. Just don't expect them to prevent or correct basic vision problems such as nearsightedness or farsightedness.

Myth: It's best not to wear glasses or contact lenses all the time. Taking a break from them allows your eyes to rest.

Fact: If you need glasses or contacts for distance or reading, use them. Not wearing your glasses will strain your eyes and tire them out instead of resting them. However, it will not worsen your vision or lead to eye disease.

Myth: Staring at a computer screen all day is bad for the eyes.

Fact: Using a computer does not damage your eyes. However, staring at a computer screen all day can contribute to eyestrain or tired eyes. People who stare at a computer screen for long periods tend not to blink as often as usual, which can cause the eyes to feel dry and uncomfortable.  To help prevent eyestrain, adjust the lighting so it doesn't create a glare or harsh reflection on the screen, rest your eyes briefly every 20 minutes, and make a conscious effort to blink regularly so that your eyes stay well lubricated.

Marijuana: Health effects of recreational and medical use

Marijuana is widely used, especially in adolescents and young adults. In the US, there are about 20 million users (about 7.5% of people aged 12 or older).
Marijuana is a mind-altering (psychoactive) drug. Similar to hemp, it comes from the cannabis plant. The plant’s primary drug effects come from the chemical delta-9-tetrahydrocannabinol, or “THC.” Marijuana is smoked, “vaped” (inhaling the vapor), or ingested in foods or teas. Over the last few decades, the concentration of THC in the cannabis plant has been increasing. In addition, the plant extracts are more potent.

Short-term effects of marijuana
Marijuana is often used for its “high,” and can make people feel more relaxed, alter the senses, and cause time distortion. It can also impair thinking, judgment, coordination, and memory. In some people, it may lead to paranoia or anxiety. Physical effects may include bloodshot eyes, dry mouth, slurred speech, and increased heart rate.
These sensations may last up to four hours after inhaling marijuana smoke, or up to 12 hours if consumed, though performance impairments may last for much longer.

Long-term effects of marijuana
Smoking marijuana can irritate the lungs and lead to breathing problems like cough, excess mucus, bronchitis, and worsening of conditions like asthma and cystic fibrosis. It is not clear if smoking marijuana is linked to lung cancer. Marijuana use during pregnancy can also harm a baby’s brain development.
We are learning more about the long-term effects of marijuana, and this leads to even more questions as we realize there is a lot we don’t know. What is clear is that some of the long-term effects correspond to heavy use. However, heavy use is difficult to define given the nature and limitations of past studies, the different ways marijuana and its extracts are used, and the shifts in THC concentration in cannabis.
The biggest health risks appear to be in those who start using as teenagers or young adults when their brains are still developing. In youths who use heavily, studies have shown deterioration in their learning and cognitive thinking that persists into adulthood, even after they have stopped using marijuana. There also appears to be a link between marijuana use and certain mental illnesses. Though most marijuana users will not develop dependence and addiction, it is more common in teenage users.

Medical benefits of marijuana
Medical use of marijuana (“medical marijuana”) is somewhat controversial. In the United States, current FDA-approved medications containing synthetic THC are dronabinol (Marinol capsules, Syndros liquid) and nabilone (Cesamet). These drugs are prescribed as appetite stimulants in AIDS patients and for chemotherapy-related nausea and vomiting. They are sometimes used off-label for similar symptoms in other conditions. An oral spray nabiximols (Sativex) is approved in other countries for treatment of multiple sclerosis muscle spasticity and cancer-related pain not managed by other pain medication, and is undergoing further evaluation in the U.S.
Although marijuana can help relieve the symptoms of certain medical conditions, its use is still illegal on a federal level, and because we don’t have data from large, long-term, well-designed studies, the FDA continues to have concerns about potential risks versus benefits. Fortunately, studies continue on marijuana, THC, and cannabidiol (a component of marijuana which does not have the mind-altering effects of THC). Early research shows cannabidiol and its derivatives hold potential promise in additional conditions like drug-resistant epilepsy and some psychiatric disorders (e.g., anxiety, substance use disorders, schizophrenia, and psychosis).
Some states have passed laws, contrary to federal laws, to allow the use of marijuana for medical conditions. Some states have also made the move to decriminalize marijuana use by adults or have similar measures on upcoming ballots. It is unclear what health impact decriminalization of marijuana would have. The experiences of other states and countries that have made these legal changes were varied and unpredictable. The greatest threat would be an increase in adolescent use.

Be cautious if you use marijuana
In the meantime, if you do use marijuana products, do not do so before driving or operating other heavy or dangerous equipment, and stop if you are pregnant. Talk to your doctor about the safety of continued use if you have a heart or lung condition, or are concerned that you might have developed an addiction. Avoid products that are packaged as candy or other edibles if there are children in your household who are more susceptible to a toxic overdose. And talk to your kids about the potential hazards of marijuana, because the risks are particularly high in young people.