Dear doctors: I take a vitamin D every day, but I also put sunscreen on my exposed skin when I go outdoors. Won't the sunscreen interfere with the effects of the vitamin D?
L.P.
Low vitamin D is increasingly being diagnosed, and has been implicated in many conditions. What is absolutely clear is that vitamin D is necessary for proper bone health, and many North Americans - particularly those who live in the northern two-thirds of the U.S. (and all Canadians) are at higher risk.
Darker-skinned people also are at higher risk for low vitamin D levels, and low vitamin D has been shown to be a reversible cause of weakness in the elderly.
Preliminary studies have linked low vitamin D to cancer, but it is too early to say whether replacing vitamin D will reduce cancer risk.
Most people make their own vitamin D with a short period of sun exposure to their face and hands, and sunscreen does indeed prevent the skin from making the active form of vitamin D in sunlight.
Since you're taking supplemental vitamin D (in the form of vitamin D-3), getting sunlight isn't necessary. You are, in effect, bypassing the skin's involvement.
Dear doctors: I take methotrexate and Remicade for rheumatoid arthritis.
Both the doctor and the pharmacist have told me not to drink alcohol with these medications. Neither one could tell me why alcohol is contraindicated.
Recently, a nurse told me that moderate drinking is OK. I am not a big drinker, but occasionally I enjoy wine with a dinner out.
However, I don't want to do anything that will affect the good results I am getting.
Do you know why alcohol is prohibited?
C.M.
The concern is damage to your liver, which is the major toxicity for methotrexate and is possible with Remicade. I won't contradict your doctor and pharmacist in your particular case. However, an occasional glass of wine (meaning a few times per month, and never more than two at a time) is unlikely to cause most people harm.
Your doctor should be monitoring your liver via blood tests, so it may be that in your case, you already have some early signs of liver involvement from the medicines. You should ask him or her if a glass of wine once or twice a month would be a problem for you.
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