Thiamine [Thiamine (vitamin B 1) is needed for the breakdown of carbohydrates.]

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Thiamine (vitamin B 1) is needed for the breakdown of carbohydrates.

Some conditions may increase your need for thiamine. These include:

  • Alcoholism
  • Burns
  • Diarrhea (continuing)
  • Fever (continuing)
  • Illness (continuing)
  • Intestinal disease
  • Liver disease
  • Overactive thyroid
  • Stress (continuing)
  • Surgical removal of stomach

Also, the following groups of people may have a deficiency of thiamine:

  • Patients using an artificial kidney (on hemodialysis)
  • Individuals who do heavy manual labor on a daily basis

Increased need for thiamine should be determined by your health care professional.

Lack of thiamine may lead to a condition called beriberi. Signs of beriberi include loss of appetite, constipation, muscle weakness, pain or tingling in arms or legs, and possible swelling of feet or lower legs. In addition, if severe, lack of thiamine may cause mental depression, memory problems, weakness, shortness of breath, and fast heartbeat. Your health care professional may treat this by prescribing thiamine for you.

Thiamine may also be used for other conditions as determined by your health care professional.

Claims that thiamine is effective for treatment of skin problems, chronic diarrhea, tiredness, mental problems, multiple sclerosis, nerve problems, and ulcerative colitis (a disease of the intestines), or as an insect repellant or to stimulate appetite have not been proven.

Injectable thiamine is administered only by or under the supervision of your health care professional. Other forms of thiamine are available without a prescription.

Importance of Diet

For good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods. If you think that you are not getting enough vitamins and/or minerals in your diet, you may choose to take a dietary supplement.

Thiamine is found in various foods, including cereals (whole-grain and enriched), peas, beans, nuts, and meats (especially pork and beef). Some thiamine in foods is lost with cooking.

Vitamins alone will not take the place of a good diet and will not provide energy. Your body also needs other substances found in food such as protein, minerals, carbohydrates, and fat. Vitamins themselves often cannot work without the presence of other foods.

The daily amount of thiamine needed is defined in several different ways.

For U.S.—

  • Recommended Dietary Allowances (RDAs) are the amount of vitamins and minerals needed to provide for adequate nutrition in most healthy persons. RDAs for a given nutrient may vary depending on a person’s age, sex, and physical condition (e.g., pregnancy).
  • Daily Values (DVs) are used on food and dietary supplement labels to indicate the percent of the recommended daily amount of each nutrient that a serving provides. DV replaces the previous designation of United States Recommended Daily Allowances (USRDAs).

For Canada—

  • Recommended Nutrient Intakes (RNIs) are used to determine the amounts of vitamins, minerals, and protein needed to provide adequate nutrition and lessen the risk of chronic disease.

Normal daily recommended intakes in milligrams (mg) for thiamine are generally defined as follows:

PersonsU.S. (mg)Canada (mg)
Infants and children
Birth to 3 years of age
0.3–0.70.3–0.6
4 to 6 years of age0.90.7
7 to 10 years of age10.8–1
Adolescent and adult males1.2–1.50.8–1.3
Adolescent and adult females1–1.10.8–0.9
Pregnant females1.50.9–1
Breast-feeding females1.61–1.2

This product is available in the following dosage forms:

  • Tablet
  • Solution

Rickets is the softening and weakening of bones in children, usually because of an vitamin D deficiency

Overview

Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. Rare inherited problems also can cause rickets.

Vitamin D helps your child’s body absorb calcium and phosphorus from food. Not enough vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets.

Adding vitamin D or calcium to the diet generally corrects the bone problems associated with rickets. When rickets is due to another underlying medical problem, your child may need additional medications or other treatment. Some skeletal deformities caused by rickets may require corrective surgery.

Rare inherited disorders related to low levels of phosphorus, the other mineral component in bone, may require other medications.

Symptoms

Signs and symptoms of rickets can include:

  • Delayed growth
  • Delayed motor skills
  • Pain in the spine, pelvis and legs
  • Muscle weakness

Because rickets softens the areas of growing tissue at the ends of a child’s bones (growth plates), it can cause skeletal deformities such as:

  • Bowed legs or knock knees
  • Thickened wrists and ankles
  • Breastbone projection

When to see a doctor

Talk to your doctor if your child develops bone pain, muscle weakness or obvious skeletal deformities.

Causes

Your child’s body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if your child’s body doesn’t get enough vitamin D or if his or her body has problems using vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D can cause rickets.

Lack of vitamin D

Children who don’t get enough vitamin D from these two sources can develop a deficiency:

  • Sunlight. Your child’s skin produces vitamin D when it’s exposed to sunlight. But children in developed countries tend to spend less time outdoors. They’re also more likely to use sunscreen, which blocks the sun’s rays that trigger the skin’s production of vitamin D.
  • Food. Fish oil, egg yolks and fatty fish such as salmon and mackerel contain vitamin D. Vitamin D has also been added to some foods and beverages, such as milk, cereal and some fruit juices.

Problems with absorption

Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include:

  • Celiac disease
  • Inflammatory bowel disease
  • Cystic fibrosis
  • Kidney problems

Risk factors

Factors that can increase a child’s risk of rickets include:

  • Dark skin. Dark skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight.
  • Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with severe vitamin D deficiency can be born with signs of rickets or develop them within a few months after birth.
  • Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets.
  • Premature birth. Babies born before their due dates tend have lower levels of vitamin D because they had less time to receive the vitamin from their mothers in the womb.
  • Medications. Certain types of anti-seizure medications and antiretroviral medications, used to treat HIV infections, appear to interfere with the body’s ability to use vitamin D.
  • Exclusive breast-feeding. Breast milk doesn’t contain enough vitamin D to prevent rickets. Babies who are exclusively breast-fed should receive vitamin D drops.

Complications

Left untreated, rickets can lead to:

  • Failure to grow
  • An abnormally curved spine
  • Bone deformities
  • Dental defects
  • Seizures

Prevention

Exposure to sunlight provides the best source of vitamin D. During most seasons, 10 to 15 minutes of exposure to the sun near midday is enough. However, if you’re dark-skinned, if it’s winter or if you live in northern latitudes, you might not be able to get enough vitamin D from sun exposure.

In addition, because of skin cancer concerns, infants and young children, especially, are warned to avoid direct sun or to always wear sunscreen and protective clothing.

To prevent rickets, make sure your child eats foods that contain vitamin D naturally — fatty fish such as salmon and tuna, fish oil and egg yolks — or that have been fortified with vitamin D, such as:

  • Infant formula
  • Cereal
  • Bread
  • Milk, but not foods made from milk, such as some yogurts and cheese
  • Orange juice

Check labels to determine the vitamin D content of fortified foods.

If you’re pregnant, ask your doctor about taking vitamin D supplements.

Guidelines recommend that all infants should receive 400 IU a day of vitamin D. Because human milk contains only a small amount of vitamin D, infants who are exclusively breast-fed should receive supplemental vitamin D daily. Some bottle-fed infants may also need vitamin D supplements if they aren’t receiving enough from their formula.

Hypercalcemia is a condition in which calcium level in your blood is above normal.

Overview

Hypercalcemia is a condition in which the calcium level in your blood is above normal. Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with how your heart and brain work.

Hypercalcemia is usually a result of overactive parathyroid glands. These four tiny glands are situated in the neck, near the thyroid gland. Other causes of hypercalcemia include cancer, certain other medical disorders, some medications, and taking too much of calcium and vitamin D supplements.

Signs and symptoms of hypercalcemia range from nonexistent to severe. Treatment depends on the cause.

Symptoms

You might not have signs or symptoms if your hypercalcemia is mild. More-severe cases produce signs and symptoms related to the parts of your body affected by the high calcium levels in your blood. Examples include:

  • Kidneys. Excess calcium makes your kidneys work harder to filter it. This can cause excessive thirst and frequent urination.
  • Digestive system. Hypercalcemia can cause stomach upset, nausea, vomiting and constipation.
  • Bones and muscles. In most cases, the excess calcium in your blood was leached from your bones, which weakens them. This can cause bone pain and muscle weakness.
  • Brain. Hypercalcemia can interfere with how your brain works, resulting in confusion, lethargy and fatigue. It can also cause depression.
  • Heart. Rarely, severe hypercalcemia can interfere with your heart function, causing palpitations and fainting, indications of cardiac arrhythmia, and other heart problems.

When to see a doctor

Contact your doctor if you develop signs and symptoms that might indicate hypercalcemia, such as being extremely thirsty, urinating frequently and having abdominal pain.

Causes

Besides building strong bones and teeth, calcium helps muscles contract and nerves transmit signals. Normally, if there isn’t enough calcium in your blood, your parathyroid glands secrete a hormone that triggers:

  • Your bones to release calcium into your blood
  • Your digestive tract to absorb more calcium
  • Your kidneys to excrete less calcium and activate more vitamin D, which plays a vital role in calcium absorption

This delicate balance between too little calcium in your blood and hypercalcemia can be disrupted by a variety of factors. Hypercalcemia is caused by:

  • Overactive parathyroid glands (hyperparathyroidism). This most common cause of hypercalcemia can stem from a small, noncancerous (benign) tumor or enlargement of one or more of the four parathyroid glands.
  • Cancer. Lung cancer and breast cancer, as well as some blood cancers, can increase your risk of hypercalcemia. Spread of cancer (metastasis) to your bones also increases your risk.
  • Other diseases. Certain diseases, such as tuberculosis and sarcoidosis, can raise blood levels of vitamin D, which stimulates your digestive tract to absorb more calcium.
  • Hereditary factors. A rare genetic disorder known as familial hypocalciuric hypercalcemia causes an increase of calcium in your blood because of faulty calcium receptors in your body. This condition doesn’t cause symptoms or complications of hypercalcemia.
  • Immobility. People who have a condition that causes them to spend a lot of time sitting or lying down can develop hypercalcemia. Over time, bones that don’t bear weight release calcium into the blood.
  • Severe dehydration. A common cause of mild or transient hypercalcemia is dehydration. Having less fluid in your blood causes a rise in calcium concentrations.
  • Medications. Certain drugs — such as lithium, used to treat bipolar disorder — might increase the release of parathyroid hormone.
  • Supplements. Taking excessive amounts of calcium or vitamin D supplements over time can raise calcium levels in your blood above normal.

Complications

Hypercalcemia complications can include:

  • Osteoporosis. If your bones continue to release calcium into your blood, you can develop the bone-thinning disease osteoporosis, which could lead to bone fractures, spinal column curvature and loss of height.
  • Kidney stones. If your urine contains too much calcium, crystals might form in your kidneys. Over time, the crystals can combine to form kidney stones. Passing a stone can be extremely painful.
  • Kidney failure. Severe hypercalcemia can damage your kidneys, limiting their ability to cleanse the blood and eliminate fluid.
  • Nervous system problems. Severe hypercalcemia can lead to confusion, dementia and coma, which can be fatal.
  • Abnormal heart rhythm (arrhythmia). Hypercalcemia can affect the electrical impulses that regulate your heartbeat, causing your heart to beat irregularly.

Vitamin K is a substance that our body needs to form clots and to stop bleeding.

What is vitamin K and why is it important?

Vitamin K is a substance that our body needs to form clots and to stop bleeding.  We get vitamin K from the food we eat.  Some vitamin K is also made by the good bacteria that live in our intestines. Babies are born with very small amounts of vitamin K stored in their bodies, which can lead to serious bleeding problems if not supplemented.

What is Vitamin K Deficiency Bleeding or VKDB?

Vitamin K deficiency bleeding or VKDB, occurs when babies cannot stop bleeding because their blood does not have enough Vitamin K to form a clot. The bleeding can occur anywhere on the inside or outside of the body.  When the bleeding occurs inside the body, it can be difficult to notice.  Commonly, a baby with VKDB will bleed into his or her intestines, or into the brain, which can lead to brain damage and even death. Infants who do not receive the vitamin K shot at birth can develop VKDB at any time up to 6 months of age. There are three types of VKDB, based on the age of the baby when the bleeding problems start: early, classical and late. More information about these types is included below.

Why are babies more likely to have vitamin K deficiency and to get VKDB?

All infants, regardless of sex, race, or ethnic background, are at higher risk for VKDB until they start eating regular foods, usually at age 4-6 months, and  until the normal intestinal bacteria start making vitamin K. This is because:

  • At birth, babies have very little vitamin K stored in their bodies because only small amounts pass to them through the placenta from their mothers.
  • The good bacteria that produce vitamin K are not yet present in the newborn’s intestines.
  • Breast milk contains low amounts of vitamin K, so exclusively breastfed babies don’t get enough vitamin K from the breast milk, alone.

What can I do to prevent my baby from getting vitamin K deficiency and VKDB?

The good news is that VKDB is easily prevented by giving babies a vitamin K shot into a muscle in the thigh.   One shot given just after birth will protect your baby from VKDB.  In order to provide for immediate bonding and contact between the newborn and mother, giving the vitamin K shot can be delayed up to 6 hours after birth.

Is the Vitamin K shot safe?

Yes.  Many studies have shown that vitamin K is safe when given to newborns.   For more information about the safety of the vitamin K shot, 

What might cause babies to be deficient in vitamin K and have bleeding problems?

Some things can put infants at a higher risk for developing VKDB. Babies at greater risk include:

  • Babies who do not receive a vitamin K shot at birth.  The risk is even higher if they are exclusively breastfed.
  • Babies whose mothers used certain medications, like isoniazid or medicines to treat seizures.  These drugs  interfere with how the body uses vitamin K.
  • Babies who have liver disease; often they cannot use the vitamin K their body stores.
  • Babies who have diarrhea, celiac disease, or cystic fibrosis often have trouble absorbing vitamins, including vitamin K, from the foods they eat.

How often are babies affected with vitamin K deficiency bleeding?

Since babies can be affected until they are 6 months old, healthcare providers divide VKDB into three types; early, classical and late.   The chart below helps explain these three different types.

  • Early and classical VKDB are more common, occurring in 1 in 60 to 1 in 250 newborns, although the risk is much higher for early VKDB among those infants whose mothers used certain medications during the pregnancy.
  • Late VKDB is rarer, occurring in 1 in 14,000 to 1 in 25,000 infants.
  • Infants who do not receive a vitamin K shot at birth are 81 times more likely to develop late VKDB than infants who do receive a vitamin K shot at birth. 

What things should I look for in my baby if I think he or she might have VKDB?

Unfortunately, in the majority of cases of VKDB, there are NO WARNING SIGNS before a life-threatening event starts.  Babies with VKDB might develop any of the following signs:

  • Bruises, especially around the baby’s head and face
  • Bleeding from the nose or umbilical cord
  • Skin color that is paler than before.  For darker skinned babies, the gums may appear pale
  • After the first 3 weeks of life, the white parts of your baby’s eyes may turn yellow.
  • Stool that has blood in it, is black or dark and sticky (also called ‘tarry’), or vomiting blood
  • Irritability, seizures, excessive sleepiness, or a lot of vomiting may all be signs of bleeding in the brain

Remember, VKDB is easily preventable with just a single vitamin K shot at birth.

A lipoma is a slow-growing, fatty lump that’s most often situated between your skin and the underlying muscle layer.

Overview

A lipoma is a slow-growing, fatty lump that’s most often situated between your skin and the underlying muscle layer. A lipoma, which feels doughy and usually isn’t tender, moves readily with slight finger pressure. Lipomas are usually detected in middle age. Some people have more than one lipoma.

A lipoma isn’t cancer and usually is harmless. Treatment generally isn’t necessary, but if the lipoma bothers you, is painful or is growing, you may want to have it removed.

Symptoms

Lipomas can occur anywhere in the body. They are typically:

  • Situated just under the skin. They commonly occur in the neck, shoulders, back, abdomen, arms and thighs.
  • Soft and doughy to the touch. They also move easily with slight finger pressure.
  • Generally small. Lipomas are typically less than 2 inches (5 centimeters) in diameter, but they can grow.
  • Sometimes painful. Lipomas can be painful if they grow and press on nearby nerves or if they contain many blood vessels.

When to see a doctor

A lipoma is rarely a serious medical condition. But if you notice a lump or swelling anywhere on your body, have it checked by your doctor.

Causes

The cause of lipomas isn’t fully understood. They tend to run in families, so genetic factors likely play a role in their development.

Risk factors

Several factors may increase your risk of developing a lipoma, including:

  • Being between 40 and 60 years old. Although lipomas can occur at any age, they’re most common in this age group.
  • Genetics. Lipomas tend to run in families.

Diagnosis

To diagnose a lipoma, your doctor may perform:

  • A physical exam
  • A tissue sample removal (biopsy) for lab examination
  • An X-ray or other imaging test, such as an MRI or CT scan, if the lipoma is large, has unusual features or appears to be deeper than the fatty

There’s a very small chance that a lump resembling a lipoma may actually be a form of cancer called liposarcoma. Liposarcomas — cancerous tumors in fatty tissues — grow rapidly, don’t move under the skin and are usually painful. A biopsy or an MRI or CT scan is typically done if your doctor suspects liposarcoma

Preparing for your appointment

You’re likely to start by seeing your family doctor or primary doctor. You may then be referred to a doctor who specializes in skin disorders (dermatologist).

Here’s some information to help you get ready for your appointment.

What you can do

  • List your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of medications, vitamins and supplements you’re taking.
  • List questions to ask your doctor.

Preparing a list of questions can help you make the most of your time with your doctor. For lipoma, some basic questions to ask include:

  • What caused this growth?
  • Is it cancer?
  • Do I need tests?
  • Will this lump always be there?
  • Can I have it removed?
  • What’s involved in removing it? Are there risks?
  • Is it likely to return, or am I likely to get another?
  • Do you have any brochures or other resources I can have? What websites do you recommend?

Don’t hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you questions, too, including:

  • When did you notice the lump?
  • Has it grown?
  • Have you had similar growths in the past?
  • Is the lump painful?
  • Have others in your family had similar lumps?

Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture.

Overview


Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone.

Osteoporosis affects men and women of all races. But white and Asian women, especially older women who are past menopause, are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

Symptoms


There typically are no symptoms in the early stages of bone loss. But once your bones have been weakened by osteoporosis, you might have signs and symptoms that include:

  • Back pain, caused by a fractured or collapsed vertebra
  • Loss of height over time
  • A stooped posture
  • A bone that breaks much more easily than expected


When to see a doctor


You might want to talk to your doctor about osteoporosis if you went through early menopause or took corticosteroids for several months at a time, or if either of your parents had hip fractures.

Causes

Comparing the interior of a healthy bone with one that has become porous from osteoporosisOsteoporosis weakens boneOpen pop-up dialog box

Your bones are in a constant state of renewal — new bone is made and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone and your bone mass increases. After the early 20s this process slows, and most people reach their peak bone mass by age 30. As people age, bone mass is lost faster than it’s created.

How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. Peak bone mass is partly inherited and varies also by ethnic group. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

Risk factors

A number of factors can increase the likelihood that you’ll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.

Unchangeable risks

Some risk factors for osteoporosis are out of your control, including:

  • Your sex. Women are much more likely to develop osteoporosis than are men.
  • Age. The older you get, the greater your risk of osteoporosis.
  • Race. You’re at greatest risk of osteoporosis if you’re white or of Asian descent.
  • Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.
  • Body frame size. Men and women who have small body frames tend to have a higher risk because they might have less bone mass to draw from as they age.

Hormone levels

Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:

  • Sex hormones. Lowered sex hormone levels tend to weaken bone. The fall in estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce estrogen levels in women are likely to accelerate bone loss.
  • Thyroid problems. Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
  • Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.

Dietary factors

Osteoporosis is more likely to occur in people who have:

  • Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Eating disorders. Severely restricting food intake and being underweight weakens bone in both men and women.
  • Gastrointestinal surgery. Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium. These surgeries include those to help you lose weight and for other gastrointestinal disorders.

Steroids and other medications

Long-term use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process. Osteoporosis has also been associated with medications used to combat or prevent:

  • Seizures
  • Gastric reflux
  • Cancer
  • Transplant rejection

Medical conditions

The risk of osteoporosis is higher in people who have certain medical problems, including:

  • Celiac disease
  • Inflammatory bowel disease
  • Kidney or liver disease
  • Cancer
  • Multiple myeloma
  • Rheumatoid arthritis

Lifestyle choices

Some bad habits can increase your risk of osteoporosis. Examples include:

  • Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem particularly helpful.
  • Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases the risk of osteoporosis.
  • Tobacco use. The exact role tobacco plays in osteoporosis isn’t clear, but it has been shown that tobacco use contributes to weak bones.

Complications

How osteoporosis can cause vertebrae to crumple and collapseCompression fracturesOpen pop-up dialog box

Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.

In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up your spine (vertebrae) can weaken to the point of collapsing, which can result in back pain, lost height and a hunched forward posture.

Prevention

Good nutrition and regular exercise are essential for keeping your bones healthy throughout your life.

Calcium

Men and women between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50 and men turn 70.

Good sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products, such as tofu
  • Calcium-fortified cereals and orange juice

If you find it difficult to get enough calcium from your diet, consider taking calcium supplements. However, too much calcium has been linked to kidney stones. Although yet unclear, some experts suggest that too much calcium, especially in supplements, can increase the risk of heart disease.

The Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine recommends that total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily for people older than 50.

Vitamin D

Vitamin D improves the body’s ability to absorb calcium and improves bone health in other ways. People can get some of their vitamin D from sunlight, but this might not be a good source if you live in a high latitude, if you’re housebound, or if you regularly use sunscreen or avoid the sun because of the risk of skin cancer.

Dietary sources of vitamin D include cod liver oil, trout and salmon. Many types of milk and cereal have been fortified with vitamin D.

Most people need at least 600 international units (IU) of vitamin D a day. That recommendation increases to 800 IU a day after age 70.

People without other sources of vitamin D and especially with limited sun exposure might need a supplement. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for most people.

Exercise

Exercise can help you build strong bones and slow bone loss. Exercise will benefit your bones no matter when you start, but you’ll gain the most benefits if you start exercising regularly when you’re young and continue to exercise throughout your life.

Combine strength training exercises with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine. Weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling especially as you get older.

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues.

Overview


Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term and can range from mild to severe. In most cases, anemia has more than one cause. See your doctor if you suspect that you have anemia. It can be a warning sign of serious illness.

Treatments for anemia, which depend on the cause, range from taking supplements to having medical procedures. You might be able to prevent some types of anemia by eating a healthy, varied diet.

Types

  • Aplastic anemia
  • Iron deficiency anemia
  • Sickle cell anemia
  • Thalassemia
  • Vitamin deficiency anemia
  • Symptoms
  • Anemia signs and symptoms vary depending on the cause and severity of anemia. Depending on the causes of your anemia, you might have no symptoms.

Signs and symptoms, if they do occur, might include:

  • Fatigue
  • Weakness
  • Pale or yellowish skin
  • Irregular heartbeats
  • Shortness of breath
  • Dizziness or lightheadedness
  • Chest pain
  • Cold hands and feet
  • Headaches
  • At first, anemia can be so mild that you don’t notice it. But symptoms worsen as anemia worsens.

When to see a doctor


Make an appointment with your doctor if you feel fatigued and you don’t know why.

Fatigue has many causes besides anemia, so don’t assume that if you’re tired you must be anemic. Some people learn that their hemoglobin is low, which indicates anemia, when they donate blood. If you’re told that you can’t donate because of low hemoglobin, make an appointment with your doctor.

Causes


Anemia can be due to a condition present at birth (congenital) or to a condition you develop (acquired). Anemia occurs when your blood doesn’t have enough red blood cells.

This can happen if:

Your body doesn’t make enough red blood cells
Bleeding causes you to lose red blood cells more quickly than they can be replaced
Your body destroys red blood cells
What red blood cells do
Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot, and red blood cells to carry oxygen from your lungs to the rest of your body and carbon dioxide from the body back to the lungs.

Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Causes of anemia


Different types of anemia have different causes. They include:

Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells.

Without iron supplementation, this type of anemia occurs in many pregnant women. It’s also caused by blood loss, such as from heavy menstrual bleeding; an ulcer in the stomach or small bowel; cancer of the large bowel; and regular use of some pain relievers that are available without a prescription, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss. It’s important to determine the source of iron deficiency to prevent recurrence of the anemia.

Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Some people who consume enough B-12 aren’t able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
Anemia of inflammation. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other acute or chronic inflammatory diseases — can interfere with the production of red blood cells.
Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.


Risk factors


These factors place you at increased risk of anemia:

A diet lacking in certain vitamins and minerals. A diet consistently low in iron, vitamin B-12, folate and copper increases your risk of anemia.
Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn’s disease and celiac disease — puts you at risk of anemia.
Menstruation. In general, women who haven’t had menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. Menstruation causes the loss of red blood cells.
Pregnancy. Being pregnant and not taking a multivitamin with folic acid and iron, increases your risk of anemia.
Chronic conditions. If you have cancer, kidney failure or another chronic condition, you could be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.

Slow, chronic blood loss from an ulcer or other source within your body can deplete your body’s store of iron, leading to iron deficiency anemia.

Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also might be at increased risk of the condition.
Other factors. A history of certain infections, blood diseases and autoimmune disorders increases your risk of anemia. Alcoholism, exposure to toxic chemicals and the use of some medications can affect red blood cell production and lead to anemia.
Age. People over age 65 are at increased risk of anemia.


Complications


Left untreated, anemia can cause many health problems, such as:

Extreme fatigue. Severe anemia can make you so tired that you can’t complete everyday tasks.
Pregnancy complications. Pregnant women with folate deficiency anemia can be more likely to have complications, such as premature birth.
Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anemic your heart pumps more blood to make up for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.
Death. Some inherited anemias, such as sickle cell anemia, can lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal. Among older people, anemia is associated with an increased risk of death.
Prevention
Many types of anemia can’t be prevented. But you can avoid iron deficiency anemia and vitamin deficiency anemias by eating a diet that includes a variety of vitamins and minerals, including:

Iron. Iron-rich foods include beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables and dried fruit.
Folate. This nutrient, and its synthetic form folic acid, can be found in fruits and fruit juices, dark green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain products, such as bread, cereal, pasta and rice.
Vitamin B-12. Foods rich in vitamin B-12 include meat, dairy products, and fortified cereal and soy products.
Vitamin C. Foods rich in vitamin C include citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries. These also help increase iron absorption.
If you’re concerned about getting enough vitamins and minerals from food, ask your doctor whether a multivitamin might help.

Rabies is a deadly virus spread to people from the saliva of infected animals.

Overview


Rabies is a deadly virus spread to people from the saliva of infected animals. The rabies virus is usually transmitted through a bite.

Animals most likely to transmit rabies in the United States include bats, coyotes, foxes, raccoons and skunks. In developing countries, stray dogs are the most likely to spread rabies to people.

Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. For this reason, anyone who may have a risk of contracting rabies should receive rabies vaccinations for protection.

Symptoms


The first symptoms of rabies may be very similar to those of the flu and may last for days.

Later signs and symptoms may include:

  • Fever
  • Headache
  • Nausea
  • Vomiting
  • Agitation
  • Anxiety
  • Confusion
  • Hyperactivity
  • Difficulty swallowing
  • Excessive salivation
  • Fear brought on by attempts to drink fluids because of difficulty swallowing water
  • Fear brought on by air blown on the face
  • Hallucinations
  • Insomnia
  • Partial paralysis


When to see a doctor


Seek immediate medical care if you’re bitten by any animal, or exposed to an animal suspected of having rabies. Based on your injuries and the situation in which the exposure happened, you and your doctor can decide whether you should receive treatment to prevent rabies.

Even if you aren’t sure whether you’ve been bitten, seek medical attention. For instance, a bat that flies into your room while you’re sleeping may bite you without waking you. If you awake to find a bat in your room, assume you’ve been bitten. Also, if you find a bat near a person who can’t report a bite, such as a small child or a person with a disability, assume that person has been bitten.

Causes


The rabies virus causes a rabies infection. The virus spreads through the saliva of infected animals. Infected animals can spread the virus by biting another animal or a person.

In rare cases, rabies can be spread when infected saliva gets into an open wound or the mucous membranes, such as the mouth or eyes. This could happen if an infected animal licked an open cut on your skin.

Animals that can transmit the rabies virus


Any mammal (an animal that suckles its young) can spread the rabies virus. The animals most likely to spread the rabies virus to people include:

  • Pets and farm animals
  • Cats
  • Cows
  • Dogs
  • Ferrets
  • Goats
  • Horses
  • Wild animals
  • Bats
  • Beavers
  • Coyotes
  • Foxes
  • Monkeys
  • Raccoons
  • Skunks
  • Woodchucks


In very rare cases, the virus has been spread to tissue and organ transplant recipients from an infected organ.

Risk factors


Factors that can increase your risk of rabies include:

  • Traveling or living in developing countries where rabies is more common
  • Activities that are likely to put you in contact with wild animals that may have rabies, such as exploring caves where bats live or camping without taking precautions to keep wild animals away from your campsite
  • Working as a veterinarian
  • Working in a laboratory with the rabies virus
  • Wounds to the head or neck, which may help the rabies virus travel to your brain more quickly


Prevention


To reduce your risk of coming in contact with rabid animals:

  • Vaccinate your pets. Cats, dogs and ferrets can be vaccinated against rabies. Ask your veterinarian how often your pets should be vaccinated.
  • Keep your pets confined. Keep your pets inside and supervise them when outside. This will help keep your pets from coming in contact with wild animals.
  • Protect small pets from predators. Keep rabbits and other small pets, such as guinea pigs, inside or in protected cages so that they are safe from wild animals. These small pets can’t be vaccinated against rabies.
  • Report stray animals to local authorities. Call your local animal control officials or other local law enforcement to report stray dogs and cats.
  • Don’t approach wild animals. Wild animals with rabies may seem unafraid of people. It’s not normal for a wild animal to be friendly with people, so stay away from any animal that seems unafraid.
  • Keep bats out of your home. Seal any cracks and gaps where bats can enter your home. If you know you have bats in your home, work with a local expert to find ways to keep bats out.
  • Consider the rabies vaccine if you’re traveling or often around animals that may have rabies. If you’re traveling to a country where rabies is common and you’ll be there for an extended period of time, ask your doctor whether you should receive the rabies vaccine. This includes traveling to remote areas where medical care is difficult to find.

If you work as a veterinarian or work in a lab with the rabies virus, get the rabies vaccine.

Amnesia refers to the loss of memories, including facts, information and experiences.

Overview


Amnesia refers to the loss of memories, including facts, information and experiences. Movies and television tend to depict amnesia as forgetting your identity, but that’s not generally the case in real life.

Instead, people with amnesia — also called amnestic syndrome — usually know who they are. But they may have trouble learning new information and forming new memories.

Amnesia can be caused by damage to areas of the brain that are vital for memory processing. Unlike a temporary episode of memory loss, called transient global amnesia, amnesia can be permanent.

There’s no specific treatment for amnesia, but treatment can be directed at the underlying cause. Tips to help enhance memory and get support can help people with amnesia and their families cope.

Symptoms


The two main features of amnesia are:

  • Trouble learning new information.
  • Trouble remembering past events and previously familiar information.

Most people with amnesia have problems with short-term memory, so they can’t retain new information. Recent memories are most likely to be lost. More-remote or deeply ingrained memories may be spared.

For example, people may recall experiences from childhood or know the names of past presidents. But they may not be able to name the current president, know the month or remember what they ate for breakfast.

Isolated memory loss doesn’t affect a person’s intelligence, general knowledge, awareness or attention span. It also doesn’t affect judgment, personality or identity. People with amnesia usually can understand written and spoken words and can learn skills such as bike riding or piano playing. They may understand they have a memory disorder.

Amnesia isn’t the same as dementia. Dementia often includes memory loss but also involves other problems with thinking that lead to a decline in daily functioning. These problems include having trouble with language, judgment and visual-spatial skills.

Memory loss also is a common symptom of mild cognitive impairment. This disorder involves memory and other cognitive problems that aren’t as severe as those experienced in dementia.

Additional symptoms


Depending on the cause of the amnesia, other symptoms may include:

  • False memories that are either completely invented or are real memories misplaced in time.
  • Confusion or disorientation.
  • When to see a doctor
  • Anyone who experiences unexplained memory loss, head injury or confusion requires immediate medical attention.

People with amnesia may not know where they are or be able to seek medical care. If someone you know has symptoms of amnesia, help the person get medical attention.

Causes


Typical memory function involves many parts of the brain. Any disease or injury that affects the brain can affect memory.

Amnesia can result from damage to brain structures that form the limbic system, which controls emotions and memories. They include the thalamus found deep within the center of the brain. They also include the hippocampal formations found within the temporal lobes of the brain.

Amnesia caused by brain injury or damage is known as neurological amnesia. Possible causes of neurological amnesia include:

  • Stroke.
  • Brain inflammation, which may be due to an infection with a virus such as herpes simplex virus. Or inflammation may be a result of an autoimmune reaction to cancer somewhere in the body. It also may be due to an autoimmune reaction in the absence of cancer.
  • Not enough oxygen in the brain. This may happen as a result of a heart attack, respiratory distress or carbon monoxide poisoning.
  • Long-term alcohol misuse that leads to too little vitamin B-1, known as thiamin, in the body. When this happens, it’s called Wernicke-Korsakoff syndrome.
  • Tumors in areas of the brain that control memory.
  • Alzheimer’s disease and other diseases that involve the degeneration of nerve tissue.
  • Seizures.
  • Certain medicines such as benzodiazepines or others that act as sedatives.
  • Head injuries that cause a concussion, whether from a car accident or sports, can lead to confusion and problems remembering new information. This is especially common in the early stages of recovery. Mild head injuries typically don’t cause lasting amnesia, but more-severe head injuries may cause permanent amnesia.

Another rare type of amnesia, called dissociative amnesia, stems from emotional shock or trauma. It can result from being the victim of a violent crime or experiencing other trauma. In this disorder, people may lose personal memories and information about their lives. The memory loss is usually brief.

Risk factors


The chance of developing amnesia might increase if you’ve experienced:

  • Brain surgery, head injury or trauma.
  • Stroke.
  • Alcohol abuse.
  • Seizures.
  • Complications
  • Amnesia varies in severity and scope. But even mild amnesia takes a toll on daily activities and quality of life. The syndrome can cause problems at work, at school and in social settings.

It may not be possible to recover lost memories. Some people with severe memory problems need to be supervised or need to live in a care facility.

Prevention


Damage to the brain can be a root cause of amnesia. It’s important to take steps to minimize your chance of a brain injury. For example:

Don’t drink large amounts of alcohol.
Wear a helmet when bicycling and a seat belt when driving.
Treat infections quickly so that they don’t have a chance to spread to the brain.
Get immediate medical treatment if you have symptoms that suggest a stroke or brain aneurysm. Those symptoms include a severe headache, feeling numb on one side of the body or not being able to move one side of the body.

Scurvy (Scurvy is better known as severe vitamin C deficiency.)

What is scurvy?


Scurvy is better known as severe vitamin C deficiency.

Vitamin C, or ascorbic acid, is an essential dietary nutrient. It plays a role in the development and functioning of several bodily structures and processes, including:

  • the proper formation of collagen, the protein that helps give your body’s connective tissues structure and stability
  • iron absorption
  • antioxidant action
  • wound healing
  • creation of neurotransmitters, like dopamine and epinephrine
  • Additionally, vitamin C may have a role in cholesterol and protein metabolism.

What are the symptoms of scurvy?


Vitamin C plays many different roles in your body. A deficiency in the vitamin causes widespread symptoms.

  • Typically, signs of scurvy begin after at least 4 weeks of severe, continual vitamin C deficiency. Generally, however, it takes 3 months or more for symptoms to develop.

Early warning signs


Early warning signs and symptoms of scurvy include:

  • weakness
  • unexplained exhaustion
  • reduced appetite
  • irritability
  • aching legs

Symptoms after 1 to 3 months


Common symptoms of untreated scurvy after 1 to 3 months include:

  • anemia, when your blood lacks enough red blood cells or hemoglobin
  • gingivitis, which causes red, soft, and tender gums that bleed easily
  • skin hemorrhages, or bleeding under your skin
  • bruise-like raised bumps at your hair follicles — often on your shins — with central hairs that appear corkscrewed (twisted) and break easily
  • large areas of reddish-blue to black bruising, often on your legs and feet
  • tooth decay
  • tender, swollen joints
  • shortness of breath
  • chest pain
  • eye dryness, irritation, and hemorrhaging in the whites of your eyes (conjunctiva) or optic nerve
  • reduced wound healing and immune health
  • light sensitivity
  • blurred vision
  • mood swings — often irritability and depression
  • gastrointestinal bleeding
  • headache


If left untreated, scurvy can cause life threatening conditions.

Severe complications of scurvy


Complications associated with long-term, untreated scurvy include:

  • severe jaundice, which is the yellowing of your skin and eyes
  • generalized pain, tenderness, and swelling
  • hemolysis, a type of anemia where red blood cells break down
  • fever
  • tooth loss
  • internal hemorrhaging
  • neuropathy, or numbness and pain usually in your lower limbs and hands
  • convulsions
  • organ failure
  • delirium
  • coma
  • Untreated scurvy can be a life threatening condition and cause death.

Pictures Of Scurvy

The bluish, red spots that occur around the hair follicles are the first signs of scurvy.