DEAR DR. ROACH: Is there a limit as to how much vitamin D should be taken a day? I am 83 years old, have taken Femara for 10 years, have had several rounds of prednisone (one for longer than a year), and I am getting about 1,950 IU of vitamin D daily. Does that sound right? —S.R.
ANSWER: Vitamin D deficiency is common throughout all of North America, and the further north you are, the more likely you are to be deficient. Older people are at higher risk, as are those with darker skin or those who aren’t outside very much.
Femara, a medication used for breast cancer, can cause accelerated bone loss, so getting the right amount of vitamin D, which helps keep bones strong, is particularly important. Prednisone, used for innumerable conditions, also causes bone loss, so you are at especially high risk.
One study gave everybody on Femara 50,000 units of vitamin D a week — about 7,000 units a day, or more than three times what you are taking — and found that such an amount of vitamin D was safe and reduced joint pain. So that may be a reasonable dose for someone on Femara.
Personally, I would recommend getting your blood level of vitamin D checked, and base your dose on the result.
Finally, most women on Femara are on for only five years. You might double-check with your oncologist about whether you should still be on it.
DEAR DR. ROACH: As I am concerned with my health, I recently decided to do some research on what I take as a daily vitamin and what the commercial companies decide to add into their pills.
One of them, selenium, was listed as being one of those dietary elements about which doctors really aren’t sure what it does for the body, but generally was thought to be beneficial for the joints and was recommended for short-term usage (I was unable to find their definition of “short-term”). The side effects stunned me, however, and it bothers me that it could contribute to higher risks of contracting diabetes. As I have diabetes in my family tree, I wonder if I should avoid vitamins containing selenium. — M.T.
ANSWER: Selenium is a mineral, a metal needed in trace amounts in the body. Selenium deficiency is certainly associated with problems, including with the immune system and the heart. However, selenium deficiency is very rare in the United States and Canada, and supplementing people with already adequate amounts of selenium does seem to increase the risk of diabetes. I don’t recommend selenium supplementation for healthy people eating a balanced diet, especially for those at higher-than-average risk for diabetes.
Incidentally, a single Brazil nut has more than a day’s worth of selenium!
DEAR DR. ROACH: Hi. I have fallen on both knees and periodically experience pain. Would you recommend ozone injections? If so, are there any risks associated with it? Any insight you provide would be appreciated. — G.G.
ANSWER: There have been some studies looking at whether ozone injections reduce pain, both in the lower back and in the knee. Initial results look promising, and risks seem to be low. However, I am pretty conservative about new treatments, and I wouldn’t rush to get these injections before further studies have been done.
READERS: Many letters ask about cervical cancer and Pap smears. The booklet on those two topics explains both. Readers can order a copy by writing: Dr. Roach — No. 1102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Keith Roach is a syndicated columnist.