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Should I be getting my vitamin D levels checked?

<a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Australia has seen a <a href="https://insightplus.mja.com.au/2023/29/gps-urged-not-to-routinely-test-children-for-vitamin-d/">surge in vitamin D testing</a> of children, with similar trends reported for adults around the <a href="https://pubmed.ncbi.nlm.nih.gov/29659534/">world</a>. GPs are now <a href="https://insightplus.mja.com.au/2023/29/gps-urged-not-to-routinely-test-children-for-vitamin-d/">being urged</a> not to test for vitamin D unnecessarily. So when is low vitamin D a potential concern? And when might you need to get your levels tested? <h2>How much vitamin D do we need?</h2> Vitamin D is not only a nutrient – when metabolised in the body it acts as a <a href="https://pubmed.ncbi.nlm.nih.gov/29080638/">hormone</a>. We have receptors for this hormone all around our body and it helps regulate the metabolism of calcium and phosphorus. Vitamin D also has many other roles, including helping our immune defences and contributing to <a href="https://pubmed.ncbi.nlm.nih.gov/11295155/">DNA repair</a> and cell differentiation. We can thank the sun for most of our vitamin D. A chemical in our skin called 7-dehydrocholesterol is converted to vitamin D after contact with UVB radiation from the sun. While we get some vitamin D also <a href="https://pubmed.ncbi.nlm.nih.gov/35253289/">through our diet</a>, this makes a relatively small contribution. It’s difficult to get much more than one-third of our daily vitamin D requirement from diet without supplementation. Nutritional vitamin D status is <a href="https://en.wikipedia.org/wiki/Calcifediol">typically measured</a> via a blood test. This checks the calcidiol (calcifediol, 25-hydroxyvitamin D) concentrations, which reflect the average intakes from the sun and diet over the past three to four weeks. The <a href="https://pubmed.ncbi.nlm.nih.gov/22708765/">current recommendation</a> is that we should all aim to have at least 50nmol/L (20ng/mL) at the end of winter. However, one problem with vitamin D tests is that there is <a href="https://pubmed.ncbi.nlm.nih.gov/37182753/">variation</a> in measured concentrations between the laboratories and between the assays, and whether you’re deemed to have a deficiency can depend on the testing method used. Doctors do not always agree with what is deficiency. While very low concentrations are likely to prompt doctors to recommend a supplement (and, potentially, follow-up testing), some may consider even relatively high concentrations as inadequate. This is all understandable as research in this space is still evolving, and we know low concentrations do not always cause any symptoms. <h2>Why avoid vitamin D deficiency?</h2> Prolonged, severe vitamin D deficiency will lead to softening of bone tissue and cause diseases such as rickets (children) and osteomalacia (adults). However, avoiding low concentrations is likely to be good for <a href="https://pubmed.ncbi.nlm.nih.gov/37483080/">many aspects of health</a>, with consistent evidence suggesting benefits for <a href="https://www.bmj.com/content/356/bmj.i6583">infectious diseases</a> and autoimmune conditions such as multiple sclerosis. Randomised trials have also provided evidence for lower <a href="https://pubmed.ncbi.nlm.nih.gov/35676320/">cancer</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/24414552/">all cause mortality</a> by daily supplementation, although any benefit is likely to be restricted to those who otherwise have insufficient intakes. <h2>Who is at risk of deficiency?</h2> Most of us do not need tests to have a relatively good idea whether we might be at risk of a clinically important deficiency. If it’s not late winter, we spend regularly at least some time outside with skin exposed to the sun, and we do not belong to a specific high-risk group, it is unlikely that our <a href="https://pubmed.ncbi.nlm.nih.gov/22168576/">levels would be very low</a>. The two main reasons for vitamin D deficiency typically relate to: 1. not getting (enough) vitamin D through sun exposure. Deficiency risk <a href="https://www.healthdirect.gov.au/vitamin-d-deficiency">can be high</a> for anyone who is housebound, such as older or disabled people in residential care. The risk of deficiency increases if we always cover our skin carefully by <a href="https://pubmed.ncbi.nlm.nih.gov/19211395/">modest cultural dress,</a> and also <a href="https://pubmed.ncbi.nlm.nih.gov/6119494/">dark skin pigmentation</a> is known to reduce vitamin D synthesis. 2. having a chronic disease that alters your requirement. Medications such as anticonvulsants used to treat epilepsy, and conditions such as <a href="https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency">liver and kidney diseases</a> can interfere with vitamin D metabolism. Some <a href="https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency">digestive diseases</a> can reduce vitamin D absorption from your diet, while <a href="https://pubmed.ncbi.nlm.nih.gov/30020507">obesity</a> will increase your vitamin D requirement and make it more difficult to raise your blood levels. <h2>Am I getting enough sun exposure?</h2> In Australia, it is possible to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. This isn’t so for many people living in the northern hemisphere. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun a few minutes on most days. The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer. During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D. If you are concerned, you have very dark skin, or are otherwise in a high-risk group, you may want to talk to your GP. In any case, taking a modest daily dose of vitamin D (1,000-2,000 IU) during the darker winter months is unlikely to cause harm and it <a href="https://pubmed.ncbi.nlm.nih.gov/37483080/">may be beneficial</a>. <h2>Why does excess vitamin D testing matter?</h2> When not indicated, testing can cause unnecessary worry and promote a cascade of <a href="https://pubmed.ncbi.nlm.nih.gov/32675268/">laboratory, prescription and imaging services</a> that are of low value. Excessive testing is also a waste of health-care resources, with one <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50619">single test</a> costing about the same as a years’ worth of vitamin D supplementation. Very often, we can make relatively small changes to our lifestyles to reduce the risks of vitamin D deficiency. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211268/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-i-be-getting-my-vitamin-d-levels-checked-211268">original article</a>.

Body

5 vitamin deficiencies your body is trying to tell you

It’s so common to have marks, bumps or blemishes on our body and just ignore them until they go away. But what if they don’t? What if your eyes, skin or hair is trying to tell you that you are lacking in a specific vitamin or mineral, which could be affecting your health and wellbeing? Speak to your doctor if you have any of these symptoms, and they can help you diagnose and treat any deficiencies. 1. Calcium deficiency Do you have weak or brittle nails, numbness in your extremities, or regular muscle cramps? Calcium deficiency could be a problem for you. It’s not just in dairy (though that is a great source) but also in seaweed, leafy greens, legumes and nuts. You can also find calcium-fortified products such as specific cereals, orange juice and soy milk. 2. Vitamin C deficiency Do you bruise more easily than you used to? Do you have cuts and wounds that seem to take a long time to heal? This could be a sign that you are low in vitamin C. And it’s not just from a lack of oranges. The best places to find this vitamin include strawberries, kiwi, broccoli and red capsicums. 3. Iron deficiency If you look unusually pale, have cold hands and feet, or a swollen tongue, you could be lacking in iron. As well as iron supplements, you can bulk up your iron intake with iron-rich foods such as red meat, fish and legumes. 4. Omega 3 deficiency Do you have bumps on the skin on your upper arms, dandruff, dry hair or dry eyes? You could be low in omega 3. Generally found in fish, seeds and nuts, leafy greens and eggs – it can also be ingested as a supplement from the chemist. 5. B12 deficiency B12 is readily available in meat, so this is a common deficiency in vegetarians and vegans. B12 is also less able to be absorbed from food as we get older. Signs of deficiency include skin irritation and dermatitis, lethargy and unusual weakness, pins and needles, and a smooth red tongue is also common (the little bumps disappear). You can get B12 in tablets or as an injection, but ideally you can get it from your food. Go for meat, leafy greens, mushrooms and nuts. Do you have any of these symptoms? Will this article encourage you to speak to your doctor to get checked out? Image: Getty

Body

Iron key to heart failure patients’ wellbeing

Patients with chronic heart failure should be made aware of the importance of having their iron levels checked regularly, with research showing half of all heart failure patients have low iron, increasing their risk of hospitalisation, which is often associated with premature death. More than half a million Australians have chronic heart failure, and it is estimated that around 158,000 will require hospitalisation each year. Hospitalisation for heart failure is associated with high rates of readmission, and death, with Australia recording an estimated 61,000 heart failure-related deaths each year. New Australian treatment guidelines recommend intravenous iron treatments rather than oral supplementation for patients with heart failure with reduced heart function who have low iron. This is in a bid to reduce the risk of hospitalisation, as oral iron has been shown to be ineffective in increasing iron levels in these patients. The updated guidelines reflect new research, including a 2020 study that found heart failure patients that received an intravenous iron treatment had a 26 per cent risk reduction in total heart failure hospitalisation, and were 21 per cent less likely to experience cardiovascular death and total heart failure hospitalisation. University Hospital Geelong cardiologist John Amerena, who co-authored the new treatment guidelines, said iron deficiency was easily diagnosed by a blood test, and should be screened for as part of routine management for heart failure patients. “Patients with heart failure with reduced heart function can experience symptoms of tiredness, restlessness, bloating and poor quality of life. These can occur regardless of whether the patient is anaemic or has experienced iron deficiency in the past,” Associate Professor Amerena said. Heart failure prevents the heart from pumping enough blood to organs and tissues and can occur as the result of conditions such as coronary artery disease, high blood pressure, heart valve defects, viral infection, or alcohol misuse. Associate Professor Amerena said heart failure patients’ chances of survival decreased with each subsequent hospitalisation, with research showing a 25 percent chance of death within one year of first hospital admission. He said evidence showed intravenous iron could improve symptoms and patient quality of life, helping to prevent rehospitalisation. Women were more typically at risk of low iron, particularly before menopause, and should have their iron levels measured regularly, particularly if they had a history of heart problems or their family members had experienced heart issues, he said. “Women should be aware that low iron is common in heart failure. Measuring iron levels should be a part of routine blood testing. If their iron stores are low, there is good evidence that the administration of intravenous iron can improve their wellbeing and functional status, as well as reducing the risk for re-hospitalisation” he said. Image: Shutterstock

Body

Low iron is a health risk made worse by COVID

“Beauty is an iron mine,” once remarked the Australian mining magnate, Gina Reinhart. She was talking about a precious resource, but iron is also profoundly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464783/" target="_blank" rel="noopener">important to living organisms</a>: from bacteria and fungi, to mammals like us. Iron acts as a key to numerous metabolic functions within our bodies. But iron deficiency remains as <a href="https://cdn.who.int/media/docs/default-source/nutritionlibrary/focusing-on-anaemia_970a28fe-a055-4e63-b3ba-11be7b940b16.pdf?sfvrsn=9ab36bdb_6&download=true" target="_blank" rel="noopener">one of the top global health risks</a> recognised by the World Health Organization (WHO). Iron deficiency has become the most prevalent micronutrient disorder worldwide, and COVID may be worsening the problem. <h2>Iron is hard to get</h2> The type of iron we mine is different from the “free-form” iron that can be used biologically. Free-form iron has a propensity to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842161/" target="_blank" rel="noopener">jump between two chemical states</a>, allowing it to bind to various molecules, and participate in all sorts of essential reactions within our bodies. But we see a different story again during food digestion. Inside our upper small intestine where iron is most effectively absorbed, free-form iron tends to bind to oxygen, other minerals and food components. This often results in rock-like, insoluble clumps (which are like the ones we mine!). These are too big to pass through or between our cells. This means that even when we consume enough iron, <a href="https://www.ncbi.nlm.nih.gov/books/NBK448204/#:%7E:text=Heme%20iron%2C%20derived%20from%20hemoglobin,and%20is%20less%20well%20absorbed." target="_blank" rel="noopener">typically only ~15–35% of it is absorbed</a>. It also means iron availability can be <a href="https://ift.onlinelibrary.wiley.com/doi/10.1111/1541-4337.12669" target="_blank" rel="noopener">improved, or inhibited</a> depending on how we eat it or what we eat it with. For example, heme iron from animal flesh has a <a href="https://omlc.org/spectra/hemoglobin/hemestruct/heme-struct.gif" target="_blank" rel="noopener">cage-like structure</a>, which carries the iron in a soluble form that prevents it from clumping during absorption. In many Western countries, heme iron only accounts for <a href="https://academic.oup.com/metallomics/article/3/2/103/6016197?login=true#219037456" target="_blank" rel="noopener">10% of the iron eaten, but two thirds</a> of the total iron absorbed. <h2>More of us are at risk of deficiency</h2> Getting sufficient iron sounds like simple maths: we want to add enough to our dietary intake to make up for the iron being lost from the body, such as through faeces, skin shedding, menstruation (for women) and sweat. But the two sides of the equation can change depending on who and where we are throughout our lifetime. Generally, iron deficiency occurs when our body’s stores of iron are depleted from not having consumed or absorbed enough iron to meet our needs. This can happen when people restrict their diets, such as for religious, social or medical reasons. Some people also have a tough time keeping up when their iron needs increase, such as <a href="https://www.nature.com/articles/s41430-019-0400-6" target="_blank" rel="noopener">pregnant women</a> and <a href="https://academic.oup.com/ajcn/article/106/suppl_6/1681S/4823199" target="_blank" rel="noopener">growing children</a>. But iron deficiency can also happen when the body has enough iron, <a href="https://onlinelibrary.wiley.com/doi/10.1111/bjh.12311" target="_blank" rel="noopener">but can’t effectively transport it into cells</a>. This is common in those with both acute and chronic infections, heart and autoimmune conditions, and cancers. In these cases, the underlying disease needs to be treated first, rather than improving iron intake. The table below summarises some common causes of iron deficiency. Sometimes multiple causes may occur simultaneously – for example, for many elite athletes (<a href="https://link.springer.com/article/10.1007/s00421-019-04157-y" target="_blank" rel="noopener">35% of women and 11% of men</a>), iron deficiency results from reduced absorption due to inflammation, on top of increased loss through sweat and breakdown of blood cells. <h2>COVID hasn’t helped</h2> The ongoing COVID epidemic has also introduced multiple risk factors for iron deficiency. We know severe infection with SARS-CoV-2 (the virus that causes COVID) may change the way some people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305218/" target="_blank" rel="noopener">metabolise iron</a>, leading to lower iron levels up to two months after infection. This <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.26774" target="_blank" rel="noopener">contributes to symptoms</a> commonly reported after infection, such as fatigue and lethargy. Recovery from the pandemic itself has also exacerbated <a href="https://www.oecd.org/coronavirus/policy-responses/food-supply-chains-and-covid-19-impacts-and-policy-lessons-71b57aea/" target="_blank" rel="noopener">food supply issues</a>, as well as the <a href="https://blogs.worldbank.org/developmenttalk/global-income-inequality-and-covid-19-pandemic-three-charts" target="_blank" rel="noopener">rising global income inequality</a>. This means more people face barriers to food security – and the nutrient-dense foods that help boost our iron intake like red meat or leafy greens may be unavailable or unaffordable for them. <h2>Before you pick up a pill</h2> It may be tempting to pick up one of the many widely available iron supplements to attempt to boost your intake. However, we have to keep in mind that conventional iron supplementation is <a href="https://www.tandfonline.com/doi/full/10.1185/03007995.2012.761599" target="_blank" rel="noopener">associated with some negative side effects</a>. These include damage to our gut lining, nausea, diarrhoea and constipation. Iron supplementation has also been linked to changes in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400826/" target="_blank" rel="noopener">gut microbiome</a>, a critical determinant of health. The WHO has recommended <a href="https://cdn.who.int/media/docs/default-source/micronutrients/gff-part-1-en.pdf?sfvrsn=afc1c426_2" target="_blank" rel="noopener">two other approaches</a>: diet diversification and food fortification. <a href="https://cdn.who.int/media/docs/default-source/anaemia/areacop-webinar---24-september-2020/areacop-webinar-nancyaburto-presentation.pdf?sfvrsn=7abd1427_4" target="_blank" rel="noopener">Diet diversification</a> is exactly as it sounds: having a diet with a variety of wholefoods such as fruits and vegetables, grains and legumes, meat, dairy, and nuts and seeds. This approach not only ensures sufficient levels of iron are found in the foods we eat, but also that they come with different forms or “vehicles” to improve absorption. This approach works <a href="https://apps.who.int/iris/bitstream/handle/10665/349086/WHO-EURO-2021-4007-43766-61591-eng.pdf?sequence=1&isAllowed=y" target="_blank" rel="noopener">even with plant-based foods</a>. Food fortification, where iron is added to processed foods, is also a fairly safe yet accessible option due to its lower dose. In Australia, iron is commonly fortified in products such as bread, cereals and ready-to-drink mixes. It can be challenging to get the iron into our body and where it’s needed. But before turning to supplements, we must remind ourselves that food sources should always be first-in-line. In cases of diagnosed deficiencies, your healthcare professional will provide you with further information where supplements are necessary. This article originally appeared on <a href="https://theconversation.com/low-iron-is-a-health-risk-made-worse-by-covid-how-to-get-more-without-reaching-for-supplements-185020" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

Vitamin C deficiency linked to cognitive impairment

A new study has found a link between poor brain function and how much Vitamin C older people have, and that a deficiency could have some serious effects on the brain. Cognitive impairment is common among older, hospitalised patients, and can result in poor memory and concentration, as well as finding decision-making difficult. The team from Flinders University in Adelaide tested the cognitive function and vitamin C level of 160 people over the age of 75 who were admitted to the university’s medical centre. From this, 91 patients were found to have cognitive impairment, and 42 of this group were found to have such low levels of vitamin C - below 11 micromoles per litre - they were at risk of developing scurvy. “Our findings showed that cognitive function scores were significantly lower among patients who were vitamin C deficient, with further analysis suggesting vitamin C deficiency was almost three times more likely to be associated with cognitive impairment after adjustment for other factors,” Associate Professor Yogesh Sharma, the study’s lead author, <a href="https://www.scimex.org/newsfeed/low-vitamin-c-linked-to-cognitive-impairment-in-older-australians" target="_blank" rel="noopener">said</a>. The researchers stressed that the two were associated, not that vitamin C deficiency causes cognitive impairment. They also noted that many of the symptoms of low vitamin C levels - including skin issues, bruising and bleeding - are common in this age group because of a number of conditions. “It may, therefore, be difficult to diagnose vitamin C deficiency solely on looking for these particular symptoms in older hospitalised patients,” Associate Professor Sharma said. “Given we know vitamin C deficiency is common among older hospitalised patients, medical professionals need to remain vigilant for this condition and confirm a patient’s vitamin C status in suspected cases.” With this link, the researchers said they will need to conduct more studies to confirm the link and determine whether replacing a patient’s vitamin C levels could help prevent or reverse cognitive impairment. The study was published in the journal <a href="https://doi.org/10.3390/antiox11030463" target="_blank" rel="noopener">Antibiotics</a>. Image: Getty Images

Body

Why dogs often need extra magnesium

It’s well-known that dogs need all the vitamins and minerals we do and one of the key nutrients is magnesium because a lack of it can cause all sorts of symptoms in dogs - in fact every time your pet moves a muscle, experiences a heartbeat or has a thought, magnesium is needed to help them achieve this. It’s little wonder many of our pets are deficient in magnesium because they share the same deficiencies as their human masters. Magnesium is very very depleted in the foods we eat these days, especially when processed. We live in a fast-food world of packets and tins, where you can bet that this type of food provides little or no magnesium benefit. <img style="width: 0px; height: 0px;" src="/nothing.jpg" alt="" data-udi="umb://media/4ebccce85d434292a659825f62146daa" />Even fresh produce can be lower in magnesium than it should be simply because the soils have become depleted of magnesium. You only have to add to this the fact that we humans and our animals lose more magnesium when we’re under stress and you can see why magnesium deficiency is very common. Many vets are aware of the importance of magnesium: <a href="https://www.shailenjasani.com/about-me/">Shailen Jasani</a> is a veterinary surgeon specialising in Emergency and Critical Care in the UK. He says magnesium can be used as a medication with an escalating role in critical care medicine, and: “Magnesium plays a pivotal role in cellular energy production and cell-specific functions in every organ of the body.” <img style="width: 0px; height: 0px;" src="/nothing.jpg" alt="" data-udi="umb://media/85906281a5614ccabe340ad9dba28740" /><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7844389/dog-magnesium-7-um.jpg" alt="" data-udi="umb://media/85906281a5614ccabe340ad9dba28740" /> Some symptoms of magnesium deficiency in dogs are: <ul> <li>Muscle weakness or trembling</li> <li>Hyperactive or improperly triggered reflexes</li> <li>Difficulty walking</li> <li>Muscle pain</li> <li>Heart arrhythmia</li> <li>Lethargy or abnormal behaviour</li> <li>Constant scratching or itching</li> <li>Difficulty sleeping</li> </ul> Causes of magnesium deficiency in dogs: <ul> <li>Excessive stress, trauma or injury</li> <li>Chemical and toxic exposures</li> <li>Malnutrition</li> <li>Diabetes</li> <li>Kidney damage</li> <li>Treatment with diuretics</li> <li>Digestion problems and disease inhibiting absorption of nutrients</li> </ul> <img style="width: 0px; height: 0px;" src="/nothing.jpg" alt="" data-udi="umb://media/c55421473c194494a9d4b17c12776f85" />More serious symptoms of heart arrhythmia: If you feel your dog is showing signs of magnesium deficiency, this should be checked out quickly to avoid serious problems. Take your dog to the vet and they’ll listen to your dog’s heart. If any abnormality is detected they’ll probably order an ECG. An ECG is a medical device which displays the patterns of your dog’s heartbeat on a screen using terminals taped to your dog’s chest. This is a simple machine and most vets have one. The classic signs of low magnesium are prolonged PR intervals, widened QRS complexes, depressed ST segments and peaked T-waves. Lower magnesium levels are also associated with hyperactivity, anxiety and agitation. You can tell if this applies to your dog if it’s hard for your dog to relax and calm down. Other minerals are also affected by magnesium deficiency in dogs Sure, there are other electrolyte minerals required by both humans and dogs. We need sodium, potassium and calcium as well, but these are all dependent to some degree on the action of the magnesium because magnesium underpins and leverages their effect. The main electrolyte team in addition to magnesium – sodium, potassium and calcium – is necessary for some very important functions, including muscle movement, proper heart function and nervous system signalling. For example, if you or your dog have plenty of magnesium, your body doesn’t need quite as much calcium to get the calcium jobs done because magnesium organises and controls calcium’s use in the body. It turns out magnesium is the ‘Master Mineral’ electrolyte regulator in the electrical system. If it drops too low, calcium can cause a lot of havoc as free calcium depositing where it shouldn’t, or over-stimulating muscle cells. Therefore, as magnesium drops lower, it can lead to the other three minerals losing effect. Studies have shown potassium suffers when magnesium is too low, as we can lose too much potassium due to membrane ‘leakiness’ when magnesium is deficient. If you lose too much potassium from inside the cell it can cause heart attacks. The potential knock-on effects are muscle weakness and tremors, as well as heart arrhythmias. As these issues escalate, they can become fatal. <img style="width: 500px; height: 281.40454995054404px;" src="https://oversixtydev.blob.core.windows.net/media/7844390/dog-magnesium-6-um.jpg" alt="" data-udi="umb://media/c55421473c194494a9d4b17c12776f85" /><img style="width: 0px; height: 0px;" src="/nothing.jpg" alt="" data-udi="umb://media/9af68fa91aa74ea2b77b8d6ace500442" /> What does all of this mean for your dog? People who own racing dogs have seen how much magnesium helps. They often apply magnesium oil to the legs of their dogs so they can recover better from their events. Without the extra magnesium the dogs develop intense and involuntary muscle tremors and spasms. This is also a helpful strategy for all athletes who undertake extreme sports and gruelling training. If your dog is behaving strangely and seems to be in pain or having trouble walking, take your pet to a vet straight away so they can check exactly what’s happening. Sometimes it might be a toxin from a tick or snake bite which is causing these issues, because these types of toxins block the electrical system. Magnesium deficiency is something which tends to grow over time. You’ll be able to notice symptoms creeping in slowly, and escalating if left untreated. If you’re worried about your dog’s health because he/she is behaving strangely with symptoms like sensitivity to stress or noises, anxiety, muscle weakness and changes to gait, or skin issues with constant scratching not due to fleas, then your vet will likely order a blood electrolyte test. This measures the amount of minerals such as magnesium, potassium, calcium and sodium in your pet’s blood, in addition to some other common electrolytes. So, once you’ve done this you’ll be able to see what your dog is low in. Treatment of magnesium deficiency in dogs If you’re feeding your dog with a variety of fresh food, but suspect magnesium deficiency (perhaps due to stress or exertion), then you can test this by applying magnesium as a magnesium spray, lotion or cream on the underbelly or legs – wherever you can get it past the fur to the skin. Avoid application of the cream to broken skin as it may sting, but rather apply to surrounding area. Apply regularly every day until the inflammation subsides. You can also add food grade magnesium chloride flakes to your dog’s drinking water every day. You can make these changes and then check to see if the symptoms they’ve been showing tend to ease. Or you can use a transdermal magnesium cream and find a way to rub this on your dog’s skin. Dogs usually love a massage so just rub in one or two teaspoons of <a href="https://www.elektramagnesium.com.au/shop/magnesium-pet-cream-50g-jar/">Magnesium Cream for Dogs</a> (Pet Cream). If your dog has developed magnesium deficiency, it’s best to keep applying the cream regularly, as well as adding the <a href="https://www.elektramagnesium.com.au/shop/magnesium-flakes/">Magnesium Chloride Flakes</a> to their drinking water, to prevent the magnesium deficiency symptoms from coming back. Images: Shutterstock

Family & Pets

Five weird signs you’re iron-deficient

Though iron is one of the most important nutrients that is needed for many functions of the body, many of us don’t get enough of it. “Iron deficiency is the most common micronutrient deficiency worldwide,” said Dr Kelly Prichett, assistant professor of sports nutrition at Central Washington University. The World Health Organisation estimates that nearly half of the world’s 1.62 billion cases of anaemia - where an individual is lacking healthy red blood cells - can be traced back to an iron deficiency. When your body is low in iron, common signs include feeling tired, faint, or becoming breathless more easily. However, there are some more unusual signs that could indicate a dip in your iron levels, including these five. 1. Odd cravings for inedible items While the reasons why are still unknown, people with severe iron deficiencies often crave non-food items including dirt, clay, paint chips, cardboard, and cleaning supplies, according to the <a rel="noopener" href="https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia" target="_blank">National Heart, Lung, and Blood Institute</a>. The condition, called pica, can be difficult to identify as many are ashamed to admit they have these unusual addictions. Pica typically occurs in young children or during pregnancy, but <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850349/" target="_blank">case studies</a> have shown that older people can experience pica too. 2. Brittle or spoon-shaped nails Fingernails can be a surprisingly good indicator about your health, including when you’re experiencing iron problems. Along with weak and brittle nails, spoon nails can be a sign of iron deficiency. Also called koilonychia, spoon nails occur when the inside of your nail sinks in, leaving your fingernail shaped like a spoon. Since spoon nails can also be caused by exposure to petroleum-based solvents, trauma (such as a jammed finger), and other issues, doctors may need to perform a blood test for iron deficiency anaemia when there aren’t any other obvious causes. 3. Dry and cracked lips While many of us are familiar with chapped lips caused by harsh cold, a dry room, or licking your lips, people with low iron levels may be prone to a more specific kind of cracking that affects the corners of the mouth, called angular cheilitis. These cracks can make it difficult to eat, smile, or even shout. In a study of 82 people with the condition, 32 percent were found to have an iron deficiency. In those cases, creams or ointments won’t do the trick and the underlying iron deficiency must be addressed to stop the cracking from coming back. 4. An oddly swollen tongue Atrophic glossitis, also known as a swollen and tender tongue, is another less-than-obvious symptom of an iron deficiency. In a <a rel="noopener" href="https://www.jfma-online.com/article/S0929-6646(13)00406-3/pdf" target="_blank">2013 study</a> of people with iron deficiency anaemia, nearly 27 percent of the 75 participants were found to have atrophic glossitis, as well as dry mouth, a burning sensation, and other oral health issues. The swelling results in the tongue appearing smooth rather than bumpy, and can cause problems with chewing, swallowing, or talking. 5. A constant craving for ice Craving ice is a specific type of pica <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/15804997/" target="_blank">called pagophagia</a>, and is one of the most common symptoms of a severe iron deficiency. While the reasons behind this craving are unclear, some experts hypothesise that chewing ice may increase alertness in iron-deficient people - who often feel sluggish and tired - or that it may soothe swollen tongues. What to do about it If you experience several of the above symptoms, booking an appointment with your doctor may be the best next step. If you are feeling more tired than usual, struggle to catch your breath while walking up stairs or exercising, feel dizzy or often feel weak, you may need to check your iron levels with your doctor. In the meantime, eating iron-rich foods such as red meat, poultry, eggs, fish, nuts, or dark leafy green vegetables can help you take in some more iron.

Body

7 signs you’re protein deficient

Whether you’re a vegetarian or an avid meat eater, protein is essential for your health. Composed of amino acids, protein is necessary for building and maintaining muscle mass, which is important whether you’re a gym junkie or a couch potato. If you’ve noticed any of the following signs, it may be time to pop more protein on your plate. <ol start="1"> <li>You’re craving food – if you find yourself desperate for a snack between breakfast, lunch and dinner, you may be eating too many carbs and sugars and not enough protein, which is essential for balancing blood sugar levels.</li> <li>You have pain in your muscles and joints – noticed you’re a bit weaker these days? Your muscles may be breaking down or joints releasing fluids to supplement the protein you’re not eating.</li> <li>You take ages to recover from injuries – protein is highly important to rebuild and mend damaged cells and tissue, so if you’re not eating enough, you may find your body takes longer to heal.</li> <li>You have weak hair, skin and nails – thinning hair, dry, cracked skin and weak, dented-looking nails are often the first signs of protein deficiency.</li> <li>You’re retaining lots of fluid – edema (fluid retention) can occur when you don’t eat enough protein, as it is responsible for preventing the accumulation of fluid in tissues, especially in the ankles and feet.</li> <li>You’re always sick – your immune cells are made from proteins, so if you’ve noticed you’re constantly sick, your immunity may have been compromised thanks to a lack of protein.</li> <li>Your mind is foggy – getting too many of your kilojoules from carbs can cause massive fluctuations in blood sugar, impeding your ability to focus. Protein helps restore the balance of blood sugar levels and removes that foggy feeling.</li> </ol> So, how much protein should you actually be eating? The recommended dietary requirement for men between 51 and 70 is 64 grams and 81 grams after the age of 70. For women, it’s 46 grams between the ages of 51 and 70 and 57 grams beyond 70. This means around 2 and a half to 3 serves of protein each day, which can come from lean meat, poultry and fish, dairy, seeds and nuts, beans and legumes, or soy products such as tofu. How do you incorporate enough protein into your diet? Tell us your tips in the comments below. Related links: <a href="/health/mind/2016/06/alzheimers-first-warning-sign/">The first warning sign of Alzheimer’s might surprise you</a> <a href="/news/news/2016/05/healthy-foods-that-are-bad-for-you/">8 “healthy” foods that are anything but</a> <a href="/news/news/2016/05/your-brain-when-you-quit-sugar/">What happens to your brain when you quit sugar</a>

Body

How to avoid omega-3 deficiency

You may be familiar with the term “omega-3s”, but what exactly are they and how can you ensure you’re meeting your nutritional requirements? Omega-3 expert Dr Bill Harris explains. More than 80 per cent of the world’s population is deficient in omega-3s, and many Australian are at risk of sub-optimal levels, due to poor dietary choices. Low levels of omega-3 may have a serious effect on your short and long-term health. But why are they so important for your health? What are omega-3s? Omega-3s are “fatty acids”. Fatty acids are the fundamental building blocks of life, like proteins and DNA, they are found in every cell in the body. Most fatty acids in the body are made from scratch by cells, but two classes cannot be made from scratch: the omega-6 and the omega-3 fatty acids – these must be obtained pre-formed from the diet. Typical western diets contain sufficient amounts of omega-6, but are now known to be low in the omega-3s. What are the different types of omega-3s? There are two most important omega-3 fatty acids are EPA – eicosapentaenoic acid and DHA - docosahexaenoic acid. These are found mainly in fish and other seafoods. A third omega-3, ALA – alpha-linolenic acid, is found in a range of plants foods, most predominantly in flax seeds, soy oil and walnuts. ALA must be converted in the body to EPA and DHA, but this is a very slow process. By including fish and seafoods in your diet two to three times a week, you'll ensure that your body is getting its required levels of the most important omega-3s. The more omega-3s you have in your cells, the better they function. Which foods can help boost my omega-3 levels? According the National Heart Foundation of Australia, Australians are recommended to include two to three servings of fish every week to obtain at least 250 to 500mg of marine-sourced (DHA+EPA) omega-3s. However, according to a recent survey, more than half (52 per cent) of Australians are not meeting this target. Your best choices are from “oily fish” such as salmon, mackerel, herring, trout, sardines, anchovies and tuna. ALA (short-chain) omega-3s are also present in some plant foods including chia seeds, walnuts and canoloa and soy oil. Can supplements help meet my nutritional omega-3 requirement? The most common way in Western countries to achieve the recommended intakes of 250 to 500 mg of EPA+DHA per day is to take an omega-3 supplement. There are many varieties, but they may be generally broken down into three categories by original source: fish, krill or algae. All three types can provide significant amounts of EPA+DHA, and they constitute the surest way to guarantee optimal intakes. Remember to always check with your healthcare practitioner to ensure that a supplement is right for you before adding to your diet. How do I know if I’m getting enough omega-3s? The only way to accurately know whether you are consuming enough omgea-3s is to test them. The <a href="http://www.omega3indexproject.com/" target="_blank">Omega-3 Index Test</a> is a simple, self-administered finger prick test, which requires one drop of blood dried on a small collection pad. This pad is sent to a laboratory for analysis, and a report is returned detailing your Index level. The target Omega-3 Index is eight per cent, above which is associated with the lowest risk for developing cardiovascular disease. An Omega-3 Index of four per cent or less is linked with a relatively high risk. Do you believe in taking supplements? Let us know in the comments below. Omega-3 Index testing is available through select practitioners and pharmacies. Please visit <a href="http://www.omega3indexproject.com/" target="_blank">www.omega3indexproject.com</a> for a full list of participants. Related links: <a href="/health/body/2016/09/high-protein-foods-to-promote-healthy-ageing/">High protein foods to promote healthy ageing</a> <a href="/news/news/2016/09/study-reveals-aussies-strange-breakfast-habits/">Study reveals Aussie’s strange breakfast habits</a> <a href="/news/news/2016/09/study-reveals-aussies-strange-breakfast-habits/">Why you should always eat skin on fruit and veggies</a><a href="/health/body/2016/08/why-you-should-always-eat-skin-on-fruit-and-veggies/"></a>

Body

Migraines caused by a lack of this essential nutrient

Anyone who regularly suffers migraines can tell you just how painful and debilitating they can be, given there are very few effective treatments. However, researchers may have just found the reason why some people are more sensitive to these dreaded headaches than others, and the answer lies in your diet. Magnesium is a nutrient crucial for a number of health reasons, but particularly when it comes to supporting the nervous system, immunity and bone strength. And now, scientists believe there’s a strong link between low levels of magnesium and migraine risk. “Migraine is widely thought of as a disorder of brain excitability,” Dr Richard Lipton of the American Migraine Foundation told <a href="http://www.self.com/wellness/2016/08/magnesium-deficiency-migraines" target="_blank">SELF</a>. “That means that under the right circumstances, attacks can be triggered – drinking a lot of red wine, not getting enough sleep, a woman’s period – because the nervous system is sensitive. “The thought is that when levels of magnesium are low, that makes nerve cells more prone to release excitatory chemicals like glutamate and that might contribute to the state of brain excitability in general.” As a result of a more excitable brain, Dr Lipton says, our risk of migraine increases. To lower the chances of an attack, he recommends aiming for a magnesium intake of 500mg a day, whether through diet or supplements. Unfortunately, though you might be tempted to reach for the dark chocolate (which is high in magnesium), Dr Lipton warns chocolate can actually be a trigger for migraines. Instead, you should opt for sources like leafy greens, pepitas, almonds, avocados and figs. Tell us in the comments below, do you suffer migraines? What’s the most effective treatment you’ve found? Related links: <a href="/news/news/2016/08/103-year-old-secret-to-long-life/">103-year-old reveals her surprising secret to a long life</a> <a href="/news/news/2016/08/unhealthy-foods-that-are-actually-good-for-you/">5 “unhealthy” foods that are actually good for you</a> <a href="/news/news/2016/08/shocking-effect-of-a-bad-nights-sleep/">The shocking effect a bad night’s sleep can have</a>

News

The long-term problems with a B12 deficiency

Vitamin B12 deficiency can cause a range of symptoms such as tiredness, weakness, constipation, loss of appetite, weight loss and megaloblastic anaemia. Nerve problems, such as numbness and tingling in the hands and feet, can also occur. Other symptoms of vitamin B12 deficiency can include problems with balance, depression, confusion, dementia, memory and soreness of the mouth or tongue. Vitamin B12 deficiency can damage the nervous system even in people who don't have anaemia, so it is important to treat a deficiency as soon as possible. From a biochemical perspective vitamin B12 plays a critical role in keeping the body's nerve and blood cells healthy and helps make DNA, the genetic material in all cells. It is absorbed in a completely different way from most nutrients, in what is essentially a two-step process. Firstly, hydrochloric acid in the stomach separates vitamin B12 from the protein to which vitamin B12 is attached in food. After this, vitamin B12 combines with a protein made by the stomach called instrinsic factor and is absorbed by the body. Pernicious anaemia is a condition where the body cannot make intrinsic factor, subsequently these people have trouble absorbing vitamin B12 from all foods and even dietary supplements. You can also see how making good levels of stomach acid is essential to vitamin B12 status, and this is becoming a problem for more and more people. Vitamin B12 is found naturally in all animal foods and is added to some vegetable-based processed foods. Plant foods do not contain vitamin B12 unless they are fortified. If you believe your vitamin B12 deficient seek the advice of your GP, as often a regular B12 injection is required. You can also help to stimulate stomach acid production with apple cider vinegar before eating to see if this assists vitamin B12 levels. Did you learn something from “Dr Libby” that you didn’t know before? Let us know in the comments below. Written by Libby Weaver. First appeared on <a href="http://Stuff.co.nz" target="_blank">Stuff.co.nz</a>. Related links: <a href="/health/body/2016/06/does-cold-weather-cause-the-flu/">Does cold weather actually cause the flu?</a> <a href="/health/body/2016/06/colorectal-surgeon-on-why-over60s-need-to-screen-for-bowel-cancer/">A colorectal surgeon on why over-60s need to screen for bowel cancer</a> <a href="/health/body/2016/06/simple-yoga-moves-to-improve-circulation/">Simple yoga moves to improve circulation</a>

Body

Plant suffer from nutrient deficiencies too

Are your plants’ foliage suffering from discolouration or pigmentation? If you’ve ruled out pests or disease, your unhappy looking plants may be suffering from a nutrient deficiency. Plants need dozens of nutrients from the soil to thrive and a lack in any of them can result in the plant growing poorly. To help you narrow down the suspects these are the most common symptoms for nutrient deficiencies in plants. In most cases, a suitable fertiliser will help you combat the situation. Signs of nutrient deficiencies in plants Nitrogen Leaves are small and light green; lower leaves lighter than upper ones; not much leaf drop; weak stalks. Phosphorus Dark-green foliage; lower leaves sometimes yellow between veins; purplish colour on leaves or petioles. Potassium Lower leaves may be mottled; dead areas near tips and margins of leaves; yellowing at leaf margins continuing toward centre. Calcium Tip of the shoot dies; tips of young leaves die; tips of leaves are hooked-shaped. Magnesium Lower leaves are yellow between veins (veins remain green); leaf margins may curl up or down or leaves may pucker; leaves die in later stages. Sulphur Tip of the shoot stays alive; light green upper leaves; leaf veins lighter than surrounding areas. Iron Tip of the shoot stays alive; new upper leaves turn yellow between veins (large veins remain green); edges and tips of leaves may die. Manganese Tip of the shoot stays alive; new upper leaves have dead spots over surface; leaf may appear netted because of small veins remaining green. Boron Tip of the shoot dies; stems and petioles are brittle. Source: Illinois College of Agricultural, Consumer and Environmental Sciences Related links: <a href="/lifestyle/gardening/2015/04/epsom-salt-in-garden/">8 great uses for Epsom salt in the garden</a> <a href="/lifestyle/gardening/2015/04/companion-planting-guide/">The companion planting guide</a> <a href="/lifestyle/gardening/2015/03/tips-for-growing-tomatoes/">Top tips for growing tomatoes</a>

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