Fatigue
To Flu or Not to Flu
“I have the flu…”
Influenza strikes every year and leaves much to be discussed. The flu statistics reveal that the highest risk groups are those 65+ years of age followed by those 0-4 years of age. The other high risk groups include pregnant women and those with chronic respiratory illness or those with weakened immune systems.
Seasonal influenza is typically the following with rapid onset:
- fever
- chills
- profound fatigue
- headaches
- joint pain
- runny nose
- cough
- sore throat
Seasonal influenza is not typically:
- nausea
- vomiting
- diarrhea
Diagnosis
The only absolute is a positive influenza swab. Unfortunately the test can 
be inaccurate. Some studies suggest the influenza swab is only 30% accurate while others suggest 70% accuracy. The best case scenario it misses 3 out of 10 individuals with influenza. This makes clinical suspicion and evaluation by your physician key in diagnosis.
Treatment
Tamiflu or other antivirals are the only prescription form of treatment but have their 
limitations. They need to be started within 48-72 hours of onset of symptoms. Antivirals when started early in the course of the illness can decrease the severity of symptoms and length of course but are not a cure. Large families or those with high risk individuals may opt to take antivirals as preventive or prophylactic care when a known influenza carrier has been diagnosed.
Supportive care is the true mainstay of care for anyone with influenza:
- fluids
- rest
- acetaminophen
Flu Vaccine
There are always lots of opinions regarding vaccination. While it is not a perfect vaccine as far as guaranteed coverage for influenza, it is safe.
The CDC recommends annual vaccination for everyone 6 months of age and older.
Vaccination is one way to protect yourself from influenza and can reduce the severity of illness if contracted and prevent hospitalizations in addition to doctor visits and time off work.
Common questions:
- Does the flu shot cause the flu?
No but can cause a flu-like response with mild headache, joint pains, and fever
- How long until I am covered after receiving the vaccination?
2 weeks
Common Sense Prevails
- avoid contact with those with symptoms
- wash your hands
- eat healthy
- exercise
- rest
Stay well!
Ann Riggs, DO
As the Sun Sets…Vitamin D Deficiency
Vitamin D Deficiency
I often joke with patients that we never checked Vitamin D levels until Dr. Oz brought it to the forefront. Thankfully he did and we are identifying more and more individuals with vitamin d deficiency and treating appropriately.
The Centers for Disease Control and Prevention (CDC) reports that 32 percent of children and adults throughout the US are vitamin D deficient. Estimates of over 95 percent of elderly are deficient.
Vitamin D Deficiency Symptoms
- Fatigue
- Bone pain
- Muscle pain
- Memory issues
- Depression
- Cardiovascular Disease
- Diabetes
- Hypertension
Vitamin D AKA the Sunshine Vitamin
How much sun is enough? You need your skin exposed without sunscreen or protective clothing interfering to be able to convert/produce Vitamin D. There is an interesting calculator here to shed some “light” on it: Sun Exposure Calculator. Keep in mind there really are so many factors(skin color, time of year, cloud cover, time of day, etc.) and to depend on the sun for your vitamin D is not ideal.
Vitamin D in our Diets
- Fish
- Egg yolks
- Fortified dairy
- Fortified grains
Risk Factors for Vitamin D Deficiency
Diets limited in the above food sources- Limited sun exposure due to occupation, climate, or darker pigmented skin
- Age
- Obesity
- GI issues that impact absorption
Vitamin D Supplementation
First and foremost check your levels before supplementing above the daily recommended allowances. Vitamin D is a fat soluble vitamin and too much can lead to toxicity issues. Basic guideline for baseline supplementation is 800-1000 International Units daily. Multi-vitamins often fall short of the baseline supplementation. Verify how much you are truly getting. If you are found to be deficient supplementation would be much higher.
Ann Riggs, DO
Tired, Foggy, and Numb?
Vitamin B12 deficiency May be Making you tired, foggy, and numb…
TIred?
Fatigue is one of the most common complaints I hear from my patients that unfortunately can be caused by many things. Vitamin B12 is one of those causes and it is quite common. Vitamin B12 plays a crucial role in energy as it aides the conversion of our foods to energy for the body.
Foggy?
Patients often complain of difficulties focusing, forgetfulness, and just a general fuzziness. Vitamin B12 helps in cognition with overall brain health. Deficiencies can also lead to general mood disorders, depression, and insomnia due to its role in production of certain natural brain chemicals.
Numb?
The classic presentation of B12 deficiency is a “stocking-glove distribution” of numbness. The hands and feet are described as numb or tingling. Vitamin B12 is utilized by the body in the maintenance and repair of the nervous system.
Other Symptoms?
- pale skin
- tongue changes–smooth, burning, or red
- heart palpitations
- shortness of breath
- diarrhea or constipation
- vision difficulties
Am I deficient?
If you have any of the above mentioned symptoms it is worth getting a simple blood test to evaluate your levels.
Risk Factors:
- age
- vegetarian/vegan
- medications that decrease absorption–classically antacid medications
- disease processes that affect absorption such as pancreatitis and inflammatory bowel diseases like Crohn’s Disease or Ulcerative Colitis
- gastric surgery for weight loss
Vitamin B12 Dietary Sources
The human body doesn’t make vitamin B12 so dietary sources are essential. Common dietary sources:
- meat
- poultry
- seafood
- dairy
- eggs
Vitamin B12 Supplement Options
Vitamin B12 supplements come in pill form, sublingual tablets, nasal sprays, and injectables. Many people can’t absorb vitamin B12 through the gut so nasal absorption, oral absorption, or injections are often preferred.
Vitamin B12 deficiency is easily detected and easily treated if you look for it…
Ann Riggs, DO
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