January Newsletter
Hello and Happy New Year! I hope your holiday season finds you well and in good spirits. On December 2, my wife Katja and I welcomed our third boy, Avery Kaelin. We had a wonderful home birth with our midwives during the snowstorm and floods! At one month, he is chubby and nursing well and has a very calm spirit.
Announcements for this newsletter include my New Year’s special: for the month of January, refer a friend for an appointment and receive a complementary treatment for yourself, good for Acupuncture or Massage.
Starting the week of January 21, 2008, clinic hours will change to allow me to see patients before and after normal work hours. If the new hours make it hard for you to keep your appointment times, let me know! If the new hours are helping you to get in more frequently, let me know that too! Tuesday 8a-3:30p, Wednesday 9a-7p, Thursday 8a-7p, Friday 8a-7p.
Also for the month of January, receive 10% off the already-below retail prices of Nordic Naturals products available at the clinic (when you mention this newsletter). Nordic Naturals features the highest quality cod liver oil, a very important supplement during the winter months (read below!).
SAD (seasonal affective disorder)
Winter is here and now is the time when we want to sleep. Our body’s natural cycles move with the sun. Melatonin is regulated by light and we are moving into the darkest time of the year. Fatigue is a natural and normal part of the winter months yet we work on a nine to five schedule throughout the year. The natural yearly rhythm is not factored into the modern lifestyle. We wake up before the sun in the winter, the we drag ourselves to work and down a cup or two of coffee to get through the morning. Many people at our latitude feel some effects from the darkness, a little sleepier, somewhat more anxious (or is that the coffee?) Living in the northwest we don’t get much sun in the winter and the summer sun is not as bright here. Our bodies are bereft of much needed UV radiation to synthesize vitamin D-a vitamin needed for immune function and emotional stability. So, how are we supposed to stay healthy and alert during the dark dreary days of winter? Allow acupuncture and simple supplements to brighten your day! Acupuncture is very good at balancing hormones, regulating emotions and aiding in depression. What is Seasonal Affective Disorder and how do we know if it’s just winter blues or a serious disorder?
Symptoms of winter-onset Seasonal Affective Disorder include:
* Depression
* Hopelessness
* Anxiety
* Loss of energy
* Social withdrawal
* Oversleeping
* Loss of interest in activities you once enjoyed
* Appetite changes, especially a craving for foods high in carbohydrates
* Weight gain
* Difficulty concentrating and processing information
Signs in Children include:
*Fatigue
*Irritability
*Academic problems
Most people in the Northwest will recognize in themselves some symptoms of this disorder. If you do, you need to determine how much it is affecting your life and consult you health care provider. The symptoms usually commence in the fall and early winter with symptoms peaking between December and February and becoming better in the spring and summer. To help fight the winter blues it is best to continue your exercise routine through out the whole year. Also you may consider a light box or dawn simulating alarm clock. There is good evidence to support the effectiveness of dawn-simulating alarm clocks. These come on with dim light and gradually increase in brightness over a period of 30 to 90 minutes leading up to the person’s normal wakening time. More research has been conducted on light boxes. If trying a light box, use it for 30 minutes in the morning after waking and at a brightness of 10,000 lux. Get a model that has a 30-day guarantee and if it isn’t working for you after three weeks send it back.
The light box and alarm clock will help with your circadian rhythm and gently telling your body it is time to wake up. The added benefit of the light box is that it will help with vitamin D synthesis. I am an advocate of vitamin D supplementation in the winter, it helps with immune function and mood symptoms. There are several ways to take D but you must be careful of what type of D you take and how much as it is a fat soluble vitamin and can build up in the body. The most bioavailable form is 25-hydroxyvitamin D (25-OH D) or D3. The natural way to get D3 is a high quality Cod Liver oil. If you prefer a specific vitamin D supplement, there is a good quality supplement on the market. For specific dosing and brands please come and see me. You may want to consult your physician for a base level of vitamin D (blood test) if you are suffering from serious effects of SAD or repeated winter illness. The two abstracts below illustrate how vitamin D is useful for SAD and immune health.
Vitamin D Protects Against Colds & Flu
It has long been observed that incidence of colds and influenza rises in the fall and winter months and wanes in the spring and summer. This is the opposite of serum levels of 25-hydroxyvitamin D, which increase in the summer and decrease dramatically as the amount of daylight diminishes. Research has shown adequate blood levels of vitamin D stimulate the genetic expression of antimicrobial peptides in human monocytes. These peptides demonstrate a broad spectrum of antimicrobial activity against viruses, bacteria, and fungi. Vitamin D also has other immune-modulating and anti-inflammatory activity.
An article published in the journal Epidemiology and Infection reports on a three-year study of 208 African-American postmenopausal women (who are at great risk of vitamin D deficiency) who were supplemented with vitamin D or placebo. For the first two years the active group received 800 IU daily, which was increased to 2,000 IU daily in the last year of the study. In the three years of the study 34 patients reported cold and flu symptoms, eight in the supplemented group and 26 in the placebo group (p<0.002). This showed that participants who got a placebo had a 300-percent greater risk of having a cold or flu, and that vitamin D supplementation provided a highly significant protective effect.
Aloia JF. Epidemic influenza and vitamin D. Epidemiol Infect 2007;135:1095-1096.’
Dr. Thomas Donahue
Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients
Reinhold Vieth, Samantha Kimball, Amanda Hu and Paul G Walfish
Background
For adults, vitamin D intake of 100 mcg (4000 IU)/day is physiologic and safe. The adequate intake (AI) for older adults is 15 mcg (600 IU)/day, but there has been no report focusing on use of this dose.
Methods
We compared effects of these doses on biochemical responses and sense of wellbeing in a blinded, randomized trial. In Study 1, 64 outpatients (recruited if summer 2001 25(OH)D <61 nmol/L) were given 15 or 100 mcg/day vitamin D in December 2001. Biochemical responses were followed at subsequent visits that were part of clinical care; 37 patients completed a wellbeing questionnaire in December 2001 and February 2002. Subjects for Study 2 were recruited if their 25(OH)D was <51 nmol/L in summer 2001. 66 outpatients were given vitamin D; 51 completed a wellbeing questionnaire in both December 2002 and February 2003.
Results
In Study 1, basal summer 25-hydroxyvitamin D [25(OH)D] averaged 48 ± 9 (SD) nmol/L. Supplementation for more than 6 months produced mean 25(OH)D levels of 79 ± 30 nmol/L for the 15 mcg/day group, and 112 ± 41 nmol/L for the 100 mcg/day group. Both doses lowered plasma parathyroid hormone with no effect on plasma calcium. Between December and February, wellbeing score improved more for the 100-mcg/day group than for the lower-dosed group (1-tail Mann-Whitney p = 0.036). In Study 2, 25(OH)D averaged 39 ± 9 nmol/L, and winter wellbeing scores improved with both doses of vitamin D (two-tail p < 0.001).
Conclusion
The highest AI for vitamin D brought summertime 25(OH)D to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional vitamin D.
Nutrition Journal 2004, 3:8
