Vitamin D basics

Maddy Draper, APRN, a health care provider at OSF OnCall, says vitamin D is a nutrient our body needs to produce calcium. Calcium helps create strong teeth and bones. So logically, not having enough vitamin D leads to brittle bones (a risk for greater injury after a fall), plus muscle aches and pains. Others with a vitamin D deficiency may not show symptoms. Either way, a provider may order a blood test to confirm the issue and then may advise you to take a supplement. This is usually in pill form and can be prescribed or bought over the counter by itself or as part of a multivitamin.

“Or the provider may just talk about vitamin D-rich foods first before starting a supplement,” Draper says. “High fat fishes, egg yolks, some cheeses and mushrooms.”

Draper adds that pregnant women, babies (especially babies who are breastfed), the elderly and people with darker skin often lack vitamin D.

On the flip side, Draper says it’s rare, but a person can get too much vitamin D. Symptoms include nausea, vomiting and heart palpitations (feeling like your heartbeat is fast, pounding or otherwise irregular). You may also suffer kidney damage.

Summer sun

Here’s advice to commit to memory: Draper says research shows 10 to 15 minutes of sun exposure three times a day can get you a healthy amount of vitamin D.

“You want to protect your skin while doing that,” Draper adds. “Sunscreen and protective clothing like a hat and sunglasses. There’s not any research showing that sunscreen or clothes will prevent you from getting the vitamin D you need.”

Experts say your sunscreen should have a sun protection factor (SPF) of 30 or higher, and you should reapply every two hours. Clothing should be lightweight and light colored (Dark colors absorb more sunlight, leading to quicker heat illness.) Stay hydrated, and watch for redness and blisters from sunburns and suspicious moles that may be skin cancer. See a provider right away if you have issues from getting too much sun.

Another thing to note: Experts say a specialized lamp can help with seasonal affective disorder, a mental health condition often seen in the winter due to decreased daylight. The same logic does not apply for vitamin D. You need natural, not artificial light to get the vitamin D you need.

The bottom line

Draper says most people don’t have to worry about getting too much or too little vitamin D.

“The average person will get it through the sun,” Draper says. “If you live in a cold and dark environment, you’re at higher risk for vitamin D deficiency. People farther away from the equator are higher risk.”

If you have symptoms of too much or too little vitamin D or just have a concern, talk to your primary care provider.

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You’ve likely heard of bronchitis, an illness that impacts the larger lung airways and leaves you feeling short of breath and just generally yucky.

This fall and winter, here’s another respiratory illness with “bronch” in the name to be aware of, especially if you have young kids: bronchiolitis. It’s an ailment that Awad Alyami, MD, an OSF HealthCare pediatrician, sees often this time of year.

The basics

Dr. Alyami says bronchiolitis is an infection of the bronchioles, or the small airways that branch out in the lungs.

“When they become infected, there is a lot of mucus. It makes it harder to breathe,” Dr. Alyami explains.

Other symptoms include fever, runny nose, cough and dehydration. Bronchiolitis is “easily spread,” Dr. Alyami says, through respiratory droplets, like when you cough. The illness is most common in children, especially kids under two. Other high-risk groups include babies born prematurely, with chronic lung disease, with heart disease present at birth and with immune system deficiencies.

“There are also environmental risk factors, like babies who are exposed to smoke and babies who attend day care,” Dr. Alyami adds. Attending day care, he explains, will expose a child to illnesses, no matter how clean the place is.

Cause, diagnosis and treatment

Dr. Alyami says other viruses like influenza and COVID-19 can cause bronchiolitis, but respiratory syncytial virus (RSV) is the most common cause.

“You need to see a doctor if your baby has trouble breathing at any time,” Dr. Alyami advises. “Or if your baby is younger than three months and they have a fever. Or if they are older than three months and they have a fever for more than three days. Or if the child has signs of dehydration, like if they are making fewer wet diapers than normal.”

Unlike the flu and COVID-19, there is no test for bronchiolitis. But, a health care provider may swab your nose anyway to see if you have another virus. Other tests like a chest x-ray may be done. And the provider will also examine you and ask about your health history to come up with a diagnosis.

Treatment involves making you feel comfortable until symptoms resolve.

“One of the most important things is nose suction as needed,” Dr. Alyami says. “When we suction the nose and keep it clean, it’s easier to breathe.”

A bulb suction is the most common device to do this. When you’re really stuffed up, you can use nasal spray or drops to make the secretion thinner. Then, use the suction. You can also use a humidifier if your home’s air is dry. Dr. Alyami says these devices and medicines are widely available in retail stores.

You can treat the fever with over-the-counter medication. Drink fluids to stay hydrated.

“Typically, day three to day five are the peak of symptoms,” Dr. Alyami says. “After five days, they start to improve. Symptoms can last seven to 14 days. And typically, the cough lingers for a little longer.”

In serious cases, your child may have low oxygen and need to be admitted to the hospital. There, doctors will use an oxygen tube inserted into the nostrils to help breathing. In rare cases, a doctor will put a breathing tube down the child’s throat.

Prevention

Want your child to avoid all this? Preach healthy habits, especially in fall and winter when respiratory illnesses peak. Wash your hands thoroughly. Cough and sneeze into your elbow or a tissue. If you’re sick, stay away from others.

Dr. Alyami adds that since RSV is the main cause of bronchiolitis, you should look into the RSV vaccine. This cold weather season, the vaccine is available for certain groups, like older adults, infants and pregnant women. Talk to your primary care provider if you have questions.

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A federal panel recently advised women get a mammogram every other year starting at age 40, rather than 50.

And the American Cancer Society estimates that in 2023, nearly 300,000 women in the United States will learn they have breast cancer. About 43,700 women will lose their life due to the disease.

The headlines are reminders to know your breast cancer risks. While many risks are out of your control, there’s just as much you can control, says Heather Thompson, a breast health navigator at OSF HealthCare.

Major risks you can control

• Active lifestyle and healthy eating: Thompson puts it plainly. If you eat junk, you’ll feel like junk. And any exercise will give you more energy and burn fat. Fat produces estrogen, which feeds cancer cells.

“You want to make sure you’re well-maintained with your weight, even after menopause,” Thompson says.

• Taking hormones: This impacts your ovaries, reducing or adding estrogen. Whether you’re at a routine appointment or you have been diagnosed with breast cancer, talk to your provider about what hormones you’re taking.

“We don’t encourage people who are having menopause symptoms [like hot flashes] to take hormones,” Thompson lists as an example. “We encourage other things to help treat those. It eliminates those estrogen cells increasing.”

• Alcohol and smoking: They are a risk for any type of cancer. But Thompson says one drink per day can increase a woman’s breast cancer risk by 12%. Alcohol is sugary, and that’s a fuel for estrogen.
   
• Night shift work: Thompson says our body expects to sleep when the sun goes down. Night work throws that off.

                “You’re getting artificial light all night. That changes the melatonin that the body naturally makes,” Thompson explains. “When your melatonin is off, it increases estrogen.”

                If you don’t work the traditional day job, see if you can work different shifts so you are not up all night all the time.

Risks you can’t control

• Age: Thompson says women generally develop breast cancer at age 50 and above. 
   
• Family history and genetic mutations: A family history of breast cancer puts you at a higher risk. Thompson says the higher risk is often seen on the person’s mother’s side of the family. For example, your mother and her sister (your aunt) may have breast cancer, and so you’d need to talk to your provider about your risk.

              Some women diagnosed with breast cancer and who have a family history may undergo a genetic test.

“Those tests can tell us if this is something being passed down from generation to generation,” Thompson says.

• Reproductive history: Young women who develop menstruation before age 12 and women who go through menopause after age 55 have an increased risk.

“That gives them a longer time with their ovaries working. They’re producing estrogen,” Thompson says.

• Dense breast: More tissue and less fat mean a dense breast and an increased cancer risk, Thompson says. Usually, the younger you are, the denser your breast is. The density of your breast is something that will be noted on every mammogram result. Thompson says mammogram technology is getting better at finding cancer in dense tissue. An early diagnosis may mean a better outcome.

Takeaways

Make sure your health care provider knows about your circumstances so they can decide on the best preventive care, like a different schedule for mammograms. Some of the information to have handy: a family history of cancer and any physical change you noticed during your monthly breast self-check.

Learn more about breast health and breast cancer care on the OSF HealthCare website.

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September is Prostate Cancer Awareness Month. It's a reminder that the disease is manageable when caught early.

Uwais Zaid, MD, a urologist who provides care at OSF HealthCare, is urging men to get screening appointments on their calendar at the right time. That’s critical, he says, because some people who develop prostate cancer will not show symptoms.

“It is something we certainly do take seriously in urology,” Dr. Zaid says.

What is the prostate?

The prostate is a male gland about the size and shape of a walnut. It surrounds the upper part of the urethra, or the tube that carries urine from the bladder. The prostate makes some of the fluid that’s part of semen.

Risk factors

Dr. Zaid says the risk for prostate cancer increases with age.

Other risks: “African American men are at a higher risk,” Dr. Zaid says. “Certain dietary things like too much red meat and greasy, fatty food. And certain type of exposures such as Agent Orange for some of our veterans.”

And like most other ailments, a family history of prostate cancer should put you on higher alert.

Screening: how and when

Dr. Zaid says prostate cancer screening involves two simple tests. One is a blood test that measures the amount of a hormone produced by your prostate called prostate-specific antigen (PSA). An abnormally high reading might warrant further examination by your health care provider.

The other test is a digital rectal exam, where your provider will feel for lumps on the prostate.

Don’t get that confused with a colonoscopy, the more invasive screening that looks for colon cancer, Dr. Zaid says.

“It doesn’t require any special or horrible bowel prep,” Dr. Zaid says of the prostate exam. “It’s about a 20 second thing we do in the clinic that can save your life.”

You should always see your health care provider anytime something seems off with your body. But the American Urological Association has guidelines for when to get a prostate cancer screening.

“For most men, we want them to start screening with an annual PSA [test] at age 54 to 69,” Dr. Zaid explains. “For certain men, you want to start earlier if you have a risk factor.”

After age 69, Dr. Zaid says you should talk to your primary care provider about what screenings are right for you.

What should you not do?

Don’t think this type of cancer is so common that you should just let it run its course. Dr. Zaid says there are aggressive types of prostate cancer that can be deadly.

Also, Dr. Zaid warns of herbal remedies for cancer in general. He says your best bet is to see a doctor.

Treatment

Dr. Zaid says treatment for prostate cancer depends, in part, on how much the cancer has spread.

If it’s contained to the prostate gland, he says radiation (sending radiation waves to destroy the cancer cells) or surgery to partially or fully remove the gland are options.

“If the prostate cancer has escaped the prostate gland, there are a lot of treatment options,” Dr. Zaid explains. “This is actually a very active area [in medicine] with all sorts of research and new medications.”

Hormone therapy may be an option here, the doctor says.

“It’s very manageable,” Dr. Zaid says on treatment of the disease.

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Recent reports from the United States Centers for Disease Control and Prevention (CDC) are again raising awareness of hepatitis C.

A 2022 report found “too few people diagnosed with hepatitis C are being treated, despite availability of medications capable of curing this viral infection.” Specifically, the agency estimates fewer than one in three people with health insurance are getting direct-acting antiviral treatment for the infection within a year of diagnosis. A June 2023 study published by the CDC also examined gaps in access to treatment, building on the 2022 findings.

The statistics resonate with Marcie Lindstrom, a gastroenterology advanced practice provider at OSF HealthCare.

“If we go back 10 or 15 years, hepatitis C treatment was really difficult,” Lindstrom notes as a possible reason for the hesitancy. “Treatment lasted a year or a year and a half. It required an injection. People really felt bad during treatment.”

Conversely: “Treatment today is so easy. It’s completed in as little as eight weeks. It’s a pill. No more injections,” Lindstrom says.

The basics

Lindstrom says hepatitis – whether A, B, C, D or E – describes inflammation of the liver. She says hepatitis C is a blood-borne virus, and doctors over the years have settled on some common ways it spreads:

• A blood transfusion prior to 1992. Prior to that time, screening blood donors for diseases was not reliable.
• A tattoo or piercing at a place that’s not regulated
• Men who have unprotected sexual relations with men
• People who use illegal drugs, either through a needle injection or snorting through the nose

“Often people are at parties and sharing a straw or dollar bill to ingest. There are a lot of blood capillaries inside the nose. Those can break open,” and blood can spread, Lindstrom says.

Lindstrom calls hepatitis C a silent ailment due to a lack of symptoms.

“Many people can have hepatitis C for decades before they become aware of it,” she says.

Even worse, when a person does have symptoms, they may be vague and tough to distinguish from everyday problems. Fatigue and body aches are common complaints.

Often, Lindstrom says a provider discovers hepatitis C after a person comes in for some routine bloodwork. The bloodwork may come back showing elevated liver enzymes, and a test specifically for hepatitis – also a simple blood test – would then be done.

But if you have any hepatitis C risk factors, you should talk to your health care provider about when you need to be screened. A provider may recommend a screening once a year. And generally, federal guidelines say all adults should be screened for hepatitis C once in their life, and all pregnant women should be tested during each pregnancy. Ask your provider about it when you’re younger rather than older, Lindstrom pleads.

Why it’s important

Untreated hepatitis C can lead to liver scarring known as cirrhosis. That means fewer cells doing their daily functions, which, in turn, can lead to liver failure, liver cancer and even death.

“That’s why treatment is important. We don’t want people to progress to getting cirrhosis,” Lindstrom says. “If they take their eight to 12 weeks of treatment and don’t have a lot of scarring, we have a high success rate in clearing the virus – 98 to 100%.”

Learn more

Read more about gastroenterology care on the OSF HealthCare website.

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