Menopause Support Blog » Blood Tests

Vitamin Vita- What’s the Big “D” Deal

Deborah McBain, CNM MSN — Tue, 29 Sep 2009 16:19:21 +0000

Seems I’m hearing a lot more about the importance of Vitamin D in the last few years. And this time of year as the days shorten and sunshine becomes a rare treat, it is timely vitamin to address. We have long understood the link between Vitamin D and bone health. Those of you who remember the practice of giving cod liver oil to children to prevent rickets are witness to this old-time knowledge. Cod liver oil is an excellent source of nutritional vitamin D. Since vitamin D is known to help absorption of calcium, menopausal women often are advised to take it with calcium to help prevent osteoporosis. Studies now suggest that Vitamin D does a whole lot more than effect the bones. Low vitamin D levels during pregnancy are being linked to more preeclampsia, low birth weight and premature labor. Low vitamin D levels in childhood are now being linked to development of asthma, diabetes and high blood pressure in later years. A recent study published in the Journal of Nutrition suggests that women with vitamin D deficiencies may have more bacterial vaginosis, a common vaginal infection. Other research links low vitamin D levels to higher rates of colon and breast cancer, depression, diabetes, heart disease, weight gain and chronic pain. Wow!

Chances are that if you live in Michigan you are vitamin D deficientor at least insufficient. Your risk is even greater if you are older, dark skinned or cover your skin while outside. Experts in the medical community generally agree that vitamin D deficiency among women is widespread. Some predict that as many as 70% of white people and 97% of black people are deficient. Vitamin D is either synthesized in the skin through exposure to ultraviolet B rays in sunlight or ingested as dietary vitamin D. However it is difficult for humans to get adequate vitamin D from diet alone. And our Michigan climate and latitude make it difficult to get enough sun exposure. Then there is the dilemma of increasing the risk of skin cancer with sun exposure. Sun screen blocks the skins ability to synthesize Vitamin D. What is a person to do?

Get your vitamin D level checked. Ask your health care provider about getting this simple blood test the next time you go for an exam.

Consider taking a supplement. There is no general agreement about the optimal intake of vitamin D. Some researchers say the current recommended intake of 400 international units (IU) to 600 IU daily is inadequate and suggest a much higher daily intake, from 1,000 IU to 5000 IU. Cholecalciferol is the preferred form. It is easily available in any drug store and not terribly expensive. If your blood levels are low your health care provider may give you with a high dose prescription form of vitamin D. Experts reassure that it is rare and dificult to get too much Vitamin D but check with your care provider.

Include nutritional sources of Vitamin D in your diet. Look for vitamin D fortified foods such as milk,cereals, orange juice and yogurt. Other foods with vitamin D include tuna, salmon, beef liver, egg yolks, cheese. ( and of course cod liver oil if you can stomach it)

Continue limited sun exposure. (if you can find it!) Most experts say that 15-30 minutes of sun exposure without sunscreen is reasonably safe. Getting this amount most days of the week can help boost most peoples vitamin D levels safely.

Dear Menopause Guru- Is this menopause?

Deborah McBain, CNM MSN — Sat, 05 Sep 2009 00:09:33 +0000

A co-worker recently e-mailed me for advice with the following information. I added the menopause guru part. OK, so maybe I’m not exactly a guru but I just thought the term fit for this. And it has kind of a nice ring to it, don’t you think? Hopefully her physician had some good reason not covered in the e-mail for doing all the testing that was done.

Dear Menopause Guru,

I wonder if you could clear up some confusion for me. Supposedly I was menopausal with hormone testing results of FSH (folicle stimulating hormone) 60 and estradiol 8 done in September of last year. Then I had a period. I had an ultrasound, and MRI and a endometrial biopsy done. These tests were all normal. Then this June I had another period. More testing with a D&C and hysteroscopy which were normal. Now my FSH is 26 and estradiol is 20. What is going on? Any thoughts?

Sincerely, Tested Out.

Dear T.O,

Well, To really give you a specific answer about your situation I would need more information. I would need to know how old you are, why the heck you had hormone testing done, how long you went without a period, medical history and other symptoms or issues etc. But I can tell you that generally one cannot diagnose menopause from hormone testing since during perimenopause there is great flucuation up and down. The only way to know for sure is no period for 12 months straight. If you did go a full year without a period then began to bleed again then it is post menopausal bleeding and of concern. But if your menopause diagnosis was solely based on your FSH/ estradiol level then you are probably perimenopausal and irregular cycles would be expected. Perimenopause can go on for several years. Generally as a woman gets closer to that final period which in retrospect is the defining moment of her menopause, periods will space out more and more. Hope this clears things up abit.

Sincerely, M.G.

Mystery of Menopause Part 1- “What’s Goin on?”

Deborah McBain, CNM MSN — Tue, 09 Sep 2008 00:57:47 +0000

Table of contents for Mystery of Menopause

Mystery of Menopause Part 1- “What’s Goin on?”
Mystery of Menopause-Part 2- “Is this Normal!?”
Mystery of Menopause- Pt 3. “Ok, so now what do I do?”- Hot Flashes and Remedies

The month’s theme for the support group meeting on Thursday, September 18 is the Mystery of Menopause. Over the next few weeks I will be addressing common questions about menopause, symptoms and treatment. I welcome your comments and questions.

Every so often a woman will come to see me and complain that her periods are getting irregular, she is having hot flashes, maybe some moodiness. “Can you give me a blood test to see if I am in menopause?” she will ask. The fact is that no women knows the exact moment when natural menopause occurs in her life. It is only after a year of no menstrual periods that anyone can know that she has reached menopause. No blood test, hormone test, medical professional or exam can tell her. Before that time she is perimenopausal (and those symptoms can last for several years). After that time until she dies, she is post menopausal (and hopefully that will last for many, many years). That single moment when the exact balance between hormones occurs and stops the monthly ebb and flow which results in menstrual bleeding is a mystery. Any blood tests done are simply a snap shot of where hormones are at that moment in time. And hormones can flucuate wildly during the perimenopausal years. Just as adolecence is a process that occurs over several years so is menopause. Perimenopausal symptoms may begin in the 30s. Natural menopause generally occurs between ages of 45-55, average 51. Before age 40 it is considered early menopause. Menopause can also be induced by surgery and with medications. Sometimes blood tests are appropriate to rule out other problems whose symtoms can mimic menopause, such as thyroid disease. If a woman is in her 40s or 50s and having typical symptoms I usually don’t need a blood test to tell her what is going on, but I certainly can help her understand the natural process and help her develop strategies to manage symptoms.

Coming, Part 2- What is normal and what is not during perimenopause and menopause.

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