134 replies to this topic

[Syedmed]

I was asked by a sister to post something in here on Vitamin D deficiency and women so I shall oblige. Recent studies, and experience have shows a prevalence of Vitamin D deficiency in muslim women, and children born to muslim women. There is a study done in 2001 at the University of Chicago that looked at religious causes of Vitamin D deficiency in infants, and concluded as such. Additionally, a retort to this study was published by pediatricians at Wake Forest University, but with similar conclusions. For the Australians in the audience, a 2002 study conducted at the University of New South Wales also looked at muslim women with vitamin D deficiency with rather startling results, and lastly a 1996 study at the University of Malmo, Sweden, specifically highlighted Muslim women as a definite risk group for vitamin D deficiency.

Now before I go on, a little disclaimer. I should let you know that in medicine, sadly, race plays a big role in disease. An African American man with join ache, sickle cell disease, a Jewish smoker with blanched fingers, Buerger's disease, certain diseases are simply attributed to certain religioun groups and certain ethnic groups, thats just the way it is.

The reason quite simply for Vitamin D deficiency in Muslim women is lifestyle in more cases than not. Vitamin D as a fat soluble vitamin that is produced by the reaction of sunlight on skin. The sunlight converts 7-DHC to Vitamin D once it is exposed to certain receptors on the skin. However, there are a few misnomers about sunlight and specifically UV absorption. Contrary to popular beleif, black does not allow UV lights to pass thru. How does this fit in, well, black hijabs, or black chadors, or even black clothing does not allow UV light to pass thru and act on the skin and produce Vitamin D.

The role of Vitamin D in the body is to increase calcium absorption in the body, both in the abdominal region, and by the kidney. This absorbed calcium is then used to enhance bone in the body. Therefore it is easy to see why Vitamin D deficiency in children causes Ricketts, and in adults leads to Osteomalacia, both disorders of bone growth and structure. However, if all it did were to cause bone disorders we could take calcium tablets and be done with it. Sadly, the human body is not as simple. The problem with vitamin D is while it is also produced by UV reaction courtesy of the sun, Vitamin D is also activated in the kidney by the action of Parathyroid Hormone, (PTH) produced by the parathyroid.

Hormone regulation in the body works by a series of checks and balances, an increase in one, leads to a decrease in another and vice versa. Vitamin D produced by the kidney is not enough really for bone health. Therefore if we are sunlight deficient, and deficient in a diet of milk, butter and eggs, our body will compensate by producing PTH. Unfortunately as mentioned before, PTH cannot compensate enough, yet the body will continue churning it out, leading eventually to a state of hyperparathyroidism, and the slim chance of a parathyroid adenoma, aka a tumor, possible cancerous (worst case).

So the lesson is this. Please do get out more into the sunlight, please dont wear exclusively black (a little tricky in Muharram, but we can work around that), and do drink your daily requisite supply of milk, etc etc. I hope this is a good enough summary for the aforementioned sister, if not, please let me know and I shall ammend it and include any potential erratum that may exist. Thank you, stay healthy, ws

[faithful_sister]

jazak Allah Khair Doc!
Alhamdulillah I drink alot of milk and I dont like to wear black because I get looks from people. <_<

wassalam

[jlainqatar]

Selam alaycom,

I wear all black, even cover my face (niqab) and don't drink milk. I recently had my vit D checked and it was normal.

Peace,
Um Ali

[Syedmed]

Sis, jlainqatar, salaam

In medicine we never say never, there are always exceptions, because that is the miracle of the human body. I am glad to hear that your Vitamin D levels are normal, ws

[Hajar]

I wear black a lot, and I am not deficent in any vitamins. I'm also not outside in the sun a lot. But I do open my curtains everyday, and let the sunlight come in my house. Is that helpful or not? Is sunlight through glass enough?

WaSalaam, Hajar

[Syedmed]

Aale Mohammad, u are 100% correct. You see cases all the time, not just of muslim women, but also orthodox jewish women who cover up as well. Glass and plastics do not allow UV rays to filter through btw sister Hajar. I think bottom line is eat healthy, and do get out more into the sun, and maybe not wear black everyday.

[sayed_ali]

Aale Mohammad, u are 100% correct. You see cases all the time, not just of muslim women, but also orthodox jewish women who cover up as well. Glass and plastics do not allow UV rays to filter through btw sister Hajar. I think bottom line is eat healthy, and do get out more into the sun, and maybe not wear black everyday.

You would see that the majority of ppl with vitamin D deficiancies are old women which leads to osteoporosis.
Why? becuase of menopause. That hightens the risk factor.
HRT is meant to help, but the real way to decrease the risk is to have had enough exposure to sunlight before getting old and plenty of excersise because that strengthens the bones.

[Batool]

bro Syedmed, could there be any other explanation for the vitamin D deficiency in the studies conducted? The group tested must have been muslim women, but can we assume that definately allthese women were in full hijjab and were also deprived of sunlight within the boundaries of their own private gardens and sunglight that reached inside their homes, and the great majority happened to be low on milk intake aswell...???

I fear that this study might be another example of alarming people with misinformation. I can accept that lack of exposure to sunlight is the cause of vitamin D difficiency, but I simply can't accpet that women in Western societies, (like Australia mentioned in the study) are generally so covered in their hijjab and kept indoors and away form sunlight to effect their vit D levels. Unless this information about the types of hijjab worn and the amount of time spent in sunglight is made available about the study group, I'm sure it is understandable to question the implication that by simply weariing a black hijjab we are at such a high risk of vit D difficiency

Thanks for the info though and thankyou bro Alle mohammed....and out of interest ..can't we just take a supplement?


your sister
Syeda

[tahira1976]

Thank you for this info.....My husband has always encouraged me to get sun where possible. If we are in the park and the park is quiet then he tells me to take off my hijab and I will have it around my neck so if I see someone approach us in our direction I just simply draw my hijab back on.....I must say that i do only feel comfortable about doing this when he is around other than that I take advantage of my parents garden which is quite secluded (as I don't have a garden). It can be hard for us sisters sometimes but Insha Allah we will be okay

salam

[Syedmed]

Sis Syeda, salaam,

The studies in question were of two types. One was a case control or retrospective study, where you look at Vitamin D deficieny in patients and you go back in time and look at exposures, or lack thereof. I believe the Australian study focused in on muslim women, but the study at the Univ. of Malmo just looked at patient data and found a trend among certain patients. The other type of study done is the cohort study, where by you take the exposure, or lack thereof, and more forward and look at the disease caused. The bottom line is this Syeda, a deficiency of sunlight is a risk factor that precludes you to certain mineal deficiencies. Whether or not you get that deficiency is another matter. Wearing a black hijab therefore may not preclude you from getting a Vitamin deficiency, but it increases the risk. And yes, you can take supplements, but a little sun isnt so bad. Lastly, it isnt a case of all these women in hijab. The way studies are done is that you have a certain set of data, and you look for correlation. In this case there is a correlation between Vitamin D deficiency and a certain group of people. The authors of the study conclude that this deficiency is most probably as as result of lifestyle and not simply chance. Every study done with statistics use what is called a p value. A p value of <0.05 shows that the data is statistically significant, and statistically viable, i.e. it was not due to chance.

[Pyarilarki06]

Was this study done to somehow discourage women from wearing hijaab because its "unhealthy"?

[jlainqatar]

Sis, jlainqatar, salaam

In medicine we never say never, there are always exceptions, because that is the miracle of the human body. I am glad to hear that your Vitamin D levels are normal, ws

Selam alaycom,

I must point out that I do go outside in the sun once a week (at my farm) without niqab, and I do eat fresh fish once or twice a week. Although I don't drink milk, I do eat yoghurt and feta cheese daily. Maybe that is the reason? I checked because I have had five kids, breastfed them all and osteoporosis runs in my mother's family. (Although they all lived on farms, had fresh milk and sunlight, go figure.)

Peace,
Um Ali

[Syedmed]

Salaam

Fresh fish, sunlight once a week, feta cheese and yoghurt, an excellent combination, thank you for sharing, much appreciated, ws

[Aale Mohammad]

osteoporosis runs in my mother's family. (Although they all lived on farms, had fresh milk and sunlight, go figure.)

The list of causes of osteoporosis is exhuastive. Vit D. deficiency is only one of them. But the main reasons are not lack of proper diet or sunlight exposure. It is estrogen deficiency in post menopausal women and lack of adequate exercise plus increased breakdown of bone in old age which leads to osteoporosis.

[Syedmed]

Bro, Aale Mohammad, salaam

What are your views on HRT therapy in post menopausal women to reduce the hot flashes and prevent osteoporosis??

[ya rahman]

Just wanted to add another point about Vit D deficiency in Asian/Muslim women. Another thing that can cause it (and its not exclusive to Muslims, many asian Hindu/Sikhs have this) is eating a lot of chapatis. This is because it's a form of unleavened bread, or something, and it prevents absorption of Vit D from the digestive system.

[Syedmed]

Speaking of Endometrium CA, the New England Journal of Medicine (NEJM) had a study out six weeks ago on a new drug to treat Breast CA with estrogen receptors that replaces Tamoxifen as standard therapy. The new drug, Exemestane, antagonizes Aromatase and if now being considered as part of a new protocol with Tamoxifen being given for 2-3 years, and then being replaced by Exemestane.

[jlainqatar]

Selam alaycom,

Excuse me drs, but the topic is vitamin D deficiency. You are hijacking the thread. Please stay on topic, you stethoscope wearing ramblers!

Peace,
Um Ali

[Syedmed]

Aale Mohammad

There have been many studies that implicate smoking and breast cancer, especially smoking early, and smoking often. In 2002 Yale University scientists found a genotype, GSTT-1 that was implicated in Breast Cancer, similar to the BRCA-1 and BRCA-2 gene that is already known about. In a study conducted, they found that in patients with the GSTT-1 genotype, there is an increased risk for developing breast cancer, especially in post menopausal women who began to smoke at a young age. A 2001 epidemiologic study done at the Medical College of Ohio alsi implicated smoking and breast cancer, and again, it is in post menopausal women who began to smoke early. There are also many studies on the risk factor on smoking being increased when concomittantly the patient is exposed to alcohol consumption. And lastly nulliparity with smoking has also been implicated. By the way, most of these studies were retrospective case-control studies.

[Syedmed]

My steth is also in my pocket. However, us medical students dont get the 4 buttons one, we get the 3 button student one, and the pockets arent deep enough for me to also carry my scut books,

Never got those people who wore it around their necks.

[Zahbon]

Salams,
I wonder how the women in Afghanistan faired those years under the Taliban? Were any Vitamin D studies done with them?
Zahra

[tahira1976]

I emailed this thread to my friend and in turn she asked a scholarly sister who she has islamic lessons from about wearing black and this is what she had to say.....


Yes it is. It is makrooh to wear black for women and its makrooh to pray salaat with black. Now I know you'll be asking about abaya and hijab, etc. You can wear all different colours under the hijab/abaya (as the idea of hijab is not to attract attention that is why I guess most wear black).

I hope this is helpful....I always thought that it was desirable to wear black....you see it in so many muslim countries.....Insha Allah I will ask her where her source of info came from....

Fi aman Illah
tahira1976

[hmMm]

thanx bro for this thread... didn't know we had such edjucational thread b4 so replying now
i really had vitamin D dilemma... actually just learned... doc just told me
well can't stop wearing black clothes
but can get my vitamin D by drinkin milk
thanx again

Edited by hmMm, 05 June 2004 - 10:48 PM.