ARE YOU GETTING YOUR VITAMIN D?

Did you know that the likelihood of you being deficient in Vitamin D is high if you are Black/Dark-Skinned, cover most of your skin when outdoors and live in the U.K?

Vitamin D is an essential nutrient for maintaining overall health and well-being. Its importance lies in its role in various bodily functions, such as maintaining strong bones and teeth, regulating the immune system, and promoting healthy cell growth and development. One of its most crucial functions is facilitating the absorption of calcium, a mineral vital for bone health. Without adequate levels of vitamin D, the body struggles to absorb calcium efficiently, leading to weakened bones and an increased risk of fractures and osteoporosis. Additionally, this sunshine vitamin plays a significant role in supporting a robust immune system, helping the body fight off infections and reducing the risk of chronic diseases. Given that natural sunlight is the primary source of vitamin D, ensuring sufficient levels of this nutrient is particularly crucial in regions with limited sunlight or during winter months when exposure to sunlight is reduced. Supplementing with vitamin D or consuming foods rich in this nutrient becomes essential in maintaining optimal health and preventing potential deficiencies.

Vitamin deficiency is a concern among people of all races and backgrounds, including Black individuals. Due to various factors, Black people may be more prone to certain vitamin deficiencies. For instance, melanin, the pigment that gives darker skin its color, can act as a barrier to absorbing sunlight, which is essential for the production of vitamin D. Consequently, Black individuals may be at a higher risk of vitamin D deficiency compared to their lighter-skinned counterparts. Additionally, certain cultural dietary preferences or restrictions may contribute to inadequate intake of vitamins such as vitamin B12 or iron. However, it is important to note that each individual is unique, and while there may be trends within racial groups, it is essential to consider individual variations and consult with healthcare professionals to address specific vitamin deficiencies in Black people.

Signs and Symptoms of Vitamin D Deficiency.

Did you know excessive sweating could be a sign of Vitamin D deficiency?

Vitamin D plays a crucial role in maintaining our overall health and well-being. However, vitamin D deficiency is becoming increasingly common, especially in areas with limited sunlight exposure. The signs and symptoms of this deficiency can vary from mild to severe. Fatigue, muscle weakness, and bone pain are common early indicators. People with low vitamin D levels may experience frequent infections and a weakened immune system. Additionally, depression, mood swings, and low mood can be attributed to inadequate vitamin D levels. In more severe cases, individuals may suffer from impaired wound healing, hair loss, and a higher risk of fractures. Recognizing these signs and symptoms is essential in order to promptly address and manage vitamin D deficiency.

Diagnosis.

Vitamin D deficiency is diagnosed through a combination of clinical examination, medical history assessment, and laboratory tests. During a clinical examination, healthcare professionals observe symptoms such as fatigue, muscle weakness, and bone pain, which may indicate a lack of vitamin D. They also take into account risk factors like limited sunlight exposure, obesity, or certain medical conditions. To confirm the diagnosis, blood tests are conducted to measure the levels of 25-hydroxyvitamin D, the active form of vitamin D, in the blood. These tests are considered the gold standard for diagnosing deficiency. Additionally, imaging tests such as X-rays or bone density scans like a Dexa Scan, may be performed to assess bone health and potential complications associated with vitamin D deficiency. The combination of thorough clinical evaluation, medical history review, and laboratory tests ensures an accurate diagnosis of vitamin D deficiency. The early detection of this deficiency plays a crucial role in initiating timely treatment and preventing long-term complications.

Prevention and Treatment.

Vitamin D deficiency is a common health issue that can lead to various complications if left untreated. To treat this deficiency, it is crucial to increase your exposure to sunlight, as sunlight is the primary source of vitamin D synthesis in the body. Spending around 10 to 15 minutes in the sun ( apply sunscreen after if you plan to stay longer and also avoid the sun between 11am to 3pm when it is at it’s strongest) at least two to three times a week can significantly assist in replenishing vitamin D levels. Additionally, incorporating foods that are naturally rich in vitamin D into your diet can be beneficial. These include fatty fish like salmon and mackerel, egg yolks, fortified dairy products, and certain mushrooms. In some cases, vitamin D supplements may be necessary, especially when sunlight exposure or dietary changes are not sufficient. However, it is important to consult with a healthcare professional before starting any supplementation to ensure appropriate dosages and monitor your progress.

So make sure you get enough Vitamin D, now that you know how vital it is to your health and well-being and talk to your doctor if you think you may have a deficiency.

Black Women and Breast Cancer: raising awareness through patient stories

NHS England and NHS Improvement feature Leicia’s story about breast cancer. Click on the link below to read more about it from their instagram page.

'Black women are twice as likely to be diagnosed with advanced breast cancer in comparison to white women. This #BreastCancerAwarenessMonth and #BlackHistoryMonth, I want to share my story to help raise awareness.' Read Leicia's story in full. https://instagram.com/p/CU7Fyn0jfUo/

Is a lack of trust and faith in the healthcare system killing your patient?

A Case Study:

Patient A died at the age of 46 from pneumonia which was as a result of complications brought on by diabetes. By the time she presented to hospital and was diagnosed with type 2 diabetes, she was in a coma and major organ damage had ensued.

Her medical history, sparse as it was, made no mention of diabetes and there was no family history of diabetes. She had been to see a doctor about aches and pains in her limbs which she had put down to arthritis but this had not been professionally diagnosed by a doctor. It was also noted that she wore spectacles , citing old age for lack of 20/20 vision. So how was it that at 46 she was dead as a result of diabetic complications? A disease she did not have as per her medical history! Had she been aware that she had type 2 diabetes? if she did, why had she not sort treatment earlier? To answer some these questions we have to go back a couple of years.

At the age of 41, patient A, a mother of 6 had left her abusive marriage after years of domestic violence that often ended up in broken bones and various bumps and bruises. She tried various business ventures to make ends meet and eventually, two years before her death she worked for her sister managing her sisters chemist. She would complain of joint pains and would often be prescribed Indomethacin ( Indocid ), a non steroidal anti-inflammatory by her doctor to help with the pains which she often referred to as arthritis. Working in a chemist gave her access to medicines and also one of her other sisters worked at a major chemist in town and would supply medicine to their sisters chemist as well. She would alternate her indocid with prednisolone and because she was not on any prescribed regime for prednisolone, her dosage depended on how much pain and discomfort she was experiencing at one given time with no formal medical over site or supervision.

It wasn’t long before she started having problems with her vision, which she put down to old age and resulted in her sister getting her a pair of spectacles from the local mission hospital. Then came the feeling of pins and needles in her legs which would result in her screaming with pain especially when she was soaking her legs after a full day of standing up at work. This was also put down to arthritis. She started experiencing what looked like restless leg syndrome which then progressed to full fits which ended in urine incontinence. The seriousness of this latest incident was what landed her in hospital attached to a drip of intravenous glucose which made her go unconscious and had to be rushed to intensive care unit where upon tests being done it was found that her blood glucose was very high and she was in a diabetic coma. It turns out she had developed steroid induced type 2 diabetes with extensive organ damage. Although she came out of the coma, she died two weeks later.

According to diabetes.org.uk, type 2 diabetes is still a silent killer as most people( a whooping 56%) are not aware they have the disease let alone know the symptoms and that most have been diagnosed by accident when they were being treated for other conditions or undergoing certain tests. Late diagnosis leaves patients open to developing serious complications like blindness, amputations, strokes, kidney disease and heart disease.

People of Black African ethnicity are three times more likely to develop type 2 diabetes than people of White European Ethnicity. It would be interesting to know out of those diagnosed, what factors were in play that lead to the diagnosis? The above scenario is an extreme example of what can happen when patients self medicate without medical supervision and ignore health symptoms. while it did not occur in the U.K, that is not to say that such can not happen here in the U.K. That is because while we have a free healthcare system, the NHS, most black people do not engage with services and are more reluctant to seek their doctors/ healthcare professionals or medical help due to previous bad experiences that they may have had or heard about. The issue of racism and two tier system within the NHS is a very real and ongoing issue that has put off black people from engaging meaningfully with any healthcare services especially screening services. As i have mentioned in earlier blog posts, most Black Africans would rather seek medical advice and treatment from their country of origin. One because they trust their own people and also you can buy almost any medication over the counter making it easier to stock up just in case you need medication to treat an ailment that would require you to navigate the healthcare system as a black person in the U.K which has been established as a barrier in itself.

Coming from Kenya I have personally experienced the worry and terror of family members and friends who stock up on all sorts of medication so that they can be ready to treat themselves before the NHS kills them! Stories of people suffering in side rooms and even dying from malaria because it was not diagnosed quickly enough as they were thought to be contagious have been doing the rounds for years not to mention the time and effort it takes to even get an appointment to be seen by a doctor only for your concerns to be fobbed off and not taken seriously, have led to a lot of mistrust of the healthcare system as a whole because as i have explained before in previous posts, going to see a doctor or even admitting that you need professional help is a big thing in African culture, it is an indication that things are serious and that all their tried and tested methods have failed.

It would be interesting to find out how many Black patients are registered with G.Ps and how many actually engage with their G.P practices? Of those who have been diagnosed with type 2 diabetes, high blood pressure or any other serious illness, how many were found accidentally during routine check up or were as a result of referrals after ending up in A&E? There is a lot that needs to be done to earn the trust and faith of Black patients and before that happens we might just end up with a scenario( if we have not already) like the one in the case study above!

While we wait for the the system to be changed and until we as black people trust, have faith and feel safe within the healthcare system, we can take steps to continue looking after our health in a safe way and using our voices and stories to highlight the health inequalities and disparities that exist in our communities, So what is steroid induced diabetes?

Long-term use of steroids like predisolone can cause diabetes but it is treatable and usually goes away once course of steroids is completed but sometimes it can lead to type 2 diabetes especially if the use of steroids has been long-term. This is because steroids can increase your blood sugar levels by:

• causing the liver to release more glucose.

• reduce your bodies sensitivity to insulin.

• stop the absorption of glucose from the body by muscle and fat cells.

You are more at risk of developing steroid induced diabetes if:

• you are of African- Caribbean, Black African or South Asian descent. and are over 25 years of age.

• Have a close family member with type 2 diabetes

• have high blood pressure

• are living with obesity.

Self medicating with steroids is dangerous and should be avoided as you just might be killing yourself! Instead:

• Only use steroids as and when prescribed and always inform your doctor or healthcare professional of any other medication you might be taking.

• Do not ignore any health concern no matter how small. Make use of walk in centres and pharmacies especially when they offer free blood pressure checks and free blood glucose checks.

• It is a good idea to get regular eye checks especially as we are on screens most of the time. an eye check can reveal a lot about your health status.

• Check out diabetes.org.uk for more information about diabetes, especially type 2 diabetes. you can also find information on the nhs website at: https://www.nhs.uk/conditions/type-2-diabetes/

SOURCES:

1. www.diabetes.org.uk

2. www.nhs.uk

3. www.lupus.org

World Elder Abuse Awareness Day

Help raise awareness and stop Elder Abuse this World Elder Abuse Awareness Day. To mark the Day, The World Health Organisation ( WHO ) has produced some handy information to help raise awareness. Find out more at:

https://www.who.int/en/news-room/fact-sheets/detail/elder-abuse