VitaminD Disease

Overview

Vitamin D disease is any condition that affects your bone density such as

• Vitamin D is a fat-soluble vitamin.
• Vitamin D and its metabolites have a significant clinical role because of their interrelationship with calcium homeostasis and bone metabolism.
•  It is also produced endogenously when ultraviolet (UV) rays from sunlight strike the skin and trigger vitamin D synthesis.

Symptoms

Common symptoms of VitaminD disease may include:

• Fatigue.
• Bone pain.
• Muscle weakness, muscle aches, or muscle cramps.
• Mood changes, like depression.

Are you at risk for VitaminD disease?

Factors that can put you at increased risk for VitaminD disease are:

• Diet: People who do not eat enough vitamin D-rich foods, including fortified dairy products and cereals, may have low levels of vitamin D.
• Lifestyle factors: Some people spend little time outdoors due to work, ill health, a lack of outdoor space in their neighborhood, or other factors. These people have less opportunity to expose their skin to sunlight. Those who wear clothes that cover all of their body, whether to protect it from the sun or for cultural or religious reasons, may also have a higher risk of a deficiency.
• Smoking: Levels of deficiency appear to be higher among smokers. Some experts have suggested that smoking may affect the gene that activates the production of vitamin D-3 in the body.
• Obesity: Research has found lower vitamin D levels in people with obesity, or a body mass index (BMI) of 30 or more. This link may be stem from the ways in which body fat affects vitamin D absorption.

Diagnosis

There are various tests used to diagnose VitaminD disease. The doctor may start by asking

• Personal and Family medical history
• Current and past symptoms
• Laboratory tests and an electrocardiogram.

Based on the results of the assessment and tests, further tests may be required

Laboratory Tests

The Laboratory tests include blood tests to determine the risk of Vitamin D disease and to evaluate other systems of the body that can affect your cardiovascular health.

Salient Blood Tests for diagnosing Vitamin D Disease

Lipid profile
The test is used to assess the risk of developing Cardiovascular disease (CVD) by measuring the amount and type of lipids (fats) in the blood. The test includes

• Total cholesterol
• LDL Cholesterol
• HDL Cholesterol
• Triglycerides
• Lipoprotein (a); Lp (a)
  
  The test is used to identify an elevated level of Lipoprotein (a) that carries cholesterol in the blood. The test evaluates the risk of developing Cardiovascular disease (CVD).
• C-reactive protein (CRP)
  
  C-reactive protein (CRP) is produced by the Liver as part of the body’s response to injury or infection. The test measures the amount of CRP in the blood to detect inflammation due to acute conditions, monitor the severity of disease in chronic conditions and helps create an overall picture of heart health.
• Homocysteine
  
  Homocysteine is used to build and maintain tissue. However, too much Homocysteine may increase the risk of heart disease and stroke. This test is usually ordered if you have a high risk of developing heart disease or have a family history of heart disease. It is also used for cases of family history of heart disease but no other known risk factors.
• HsCRP
  
  New age test to assess the risk of developing heart attack, stroke. It accurately measures low but persistent levels of inflammation in the body that is associated with Atherosclerosis
• CK-MB
  
  Creatine kinase-MB (CK-MB) is a form of an enzyme found primarily in heart muscle cells. This test measures CK-MB in the blood. CK-MB will typically only be present in significant amounts when the heart is damaged.
• Troponin – T, I (High Sensitive)
  
  High-sensitivity troponin tests are primarily ordered to help diagnose a heart attack and rule out other conditions with similar signs and symptoms. Levels of troponin can become elevated in the blood within 3 to 6 hours after heart injury and may remain elevated for 10 to 14 days.
• BNP and NT-proBNP
  
  B-type natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP) are released by the body as a natural response to heart failure. Tests for BNP and NT-proBNP measure their levels in the blood to detect and evaluate heart failure.
• APOLIPOPROTEINS A1 & B
  
  Apo A-1 is the main protein component of HDL, the “good cholesterol”. Apo B is the main protein associated with LDL, the “bad cholesterol”.
  Apo A-1 and Apo B are better indicators than LDL Cholesterol etc and determine the risk of developing cardiovascular disease (CVD)

Blood Tests for Other Body Systems

• Complete blood count (CBC) CBC is a series of tests that measure red blood cells, white blood cells and platelets.
• Sodium and potassium levels Sodium and potassium levels help in detecting a problem with electrolytes in the body fluids.
• Blood urea nitrogen and Creatinine Blood urea nitrogen and creatinine are measured to check kidney function.
• Fasting glucose Fasting glucose is performed to diagnose diabetes or pre-diabetes.
• TSH TSH is measured to check thyroid function.

Non Invasive Tests

• Electrocardiogram
  
  CBC is a series of tests that measure red blood cells, white blood cells and platelets.
• Stress EKG
  
  Stress tests are performed to see how the heart performs under physical stress e.g. with exercise on a treadmill. The EKG wires record electrical signals of the heart while exercising along with Blood Pressure.
• Thallium Scan
  
  It involves a treadmill stress test and scanning of the heart via nuclear camera after injection of a radionuclide material. It determines the amount of blood the heart muscle is receiving during rest and stress.
• Carotid Ultrasound
  
  Carotid ultrasound is used to evaluate the risk of stroke. A small probe called a transducer is gently pushed against the sides of the neck, which sends images of arteries to a computer screen. It is used to check for Stenosis by monitoring blood flow through the carotid arteries on both sides of the neck.
• Holter Monitor
  
  A Holter monitor enables continuous recording of EKG during your daily activities. It can detect arrhythmias that might not show up on a resting EKG.

Invasive Tests

Cardiac Catheterization and Coronary Angiography

Cardiac catheterization is a common procedure that helps to diagnose heart disease. It is also used to treat heart disease by opening blocked arteries with balloon angioplasty and stent placement.

It helps the doctor to know if
• The blood vessels in the heart have narrowed
• The heart is pumping normally
• The valves in the heart are functioning normally
• There are any congenital heart abnormalities.
• The pressures in the heart and the lungs are normal.