Telehealth available for follow up as well as new consultations. Please contact us Here.
1-818-812-7222 Office Hours: 8:00 AM to 5:00 PM
10 Congress St., Suite #405
Pasadena, CA 91105

August 6, 2014 Group Meeting Recap

Posted On : August 08, 2014

August’s group meeting/webinar topic was Vitamin D.  Dr. Keshishian will be adding the voice over to the slides and it will be uploaded to  when it’s completed.  But in the meantime here are some highlights. Webinar here.

Vitamin D is a fat soluble vitamin has many important functions including bone health, cardiovascular health, blood glucose regulation, anti-cancer, anti-inflammatory, muscle function, respirator function, brain development and health, and immune function.  There are several very large studies investigating other functions of Vitamin D.  Vitamin D knowledge is in the midst of huge changes due to these upcoming studies.

Vitamin D metabolism is a complicated process whether via photo conversion in the skin or supplementation. Either way Vitamin D metabolism requires cholesterol to be converted to its active form.  The fat-solubility is the primary reason for deficiency after Doudenal Switch, due to malabsorption of fat needed for conversion of Vitamin D. The Parathyroid gland helps to regulate absorption of Vitamin D.  It is an inverse mechanism, meaning a high Parathyroid level signals more absorption of Vitamin D and calcium also.

August 6, 2014 Group Meeting Recap
August 6, 2014 Group Meeting Recap

Vitamin D deficiency is a World Health Organization priority. There are several causes some related to sunscreen use, disease processes, WLS, cola intake, diet related and medications.  These can compound Vitamin D deficiencies.

August 6, 2014 Group Meeting Recap
August 6, 2014 Group Meeting Recap

Dr. Keshishian has new guide lines for Vitamin D levels.  Due to the changing research regarding Vitamin D these guidelines are changing.  There are some endocrinologists in Vitamin D research that are recommending even high standard of Vitamin D. DS patients should be well above the border of insufficient and sufficient due to underlining contributing facts for deficiencies and the lack of absorption. Parathyroid Hormone levels are inversely related.  High PTH level can indicate Vitamin D deficiency and increase need for calcium.  Calcium blood levels are not a good indicator of calcium  or Vitamin D needs as the body is efficient at maintaining Calcium blood levels by breaking down bone mass due to the critic bodies need for circulating calcium.

August 6, 2014 Group Meeting Recap
August 6, 2014 Group Meeting Recap

Supplementation options are as follows: Please note that most over the counter Vitamin D is not appropriate for DS absorption.  DS patients need to take “Dry” water miscible Vitamin D3. Please see the previous blog post regarding https://blog.dssurgery.com/2013/08/vitamin-d-and-dry-water-soluble.html for more information and pictures of this type of Vitamin D. Vitamin D is tied to several other nutrients for metabolism such as protein, calcium, magnesium, zinc and potassium.  Treatment for correcting iron deficiency and phosphorus intake counter act Vitamin D absorption as do other previous discussed dietary issues. Take oral Vitamin D supplements even if you are receiving injectable Vitamin D.

August 6, 2014 Group Meeting Recap
August 6, 2014 Group Meeting Recap

Be proactive in Vitamin D supplements by monitoring your yearly DS laboratory studies.  Please call the office with any questions.  If in need of Vitamin D injections please see the previous blog post for related research article and compounding  pharmacies.  Vitamin D injections are not common place.
Please take the Vitamin D injections post to your treating physician if you are unable to see Dr. Keshishian and are in need of Vitamin D injections. If your treating physician has any questions please let them know Dr. Keshishian is available to answer their questions.

Our food selections for the meeting where all high Vitamin D recipes.  Tuna stuff mushroom (Tuna for Vitamin D and mushrooms are a good source of zinc), crustless artichoke and spinach quiche ignore the part of the recipe for the crust and just bake in pie plate without the crust, Panna cotta with a strawberry balsamic compote and toasted flax seed and hemp hulls.   The panna cotta is made with milk or almond milk and gelatin which are all important in bone health.  Hemp hulls are a protein source as is the milk.

Strawberry Balsamic Compote taken from https://nomnompaleo.com
1/4 C balsamic Vinegar
2C hulled strawberries, thinly sliced
2 TBSP honey
1 TBSP fresh lemon juice
1tsp vanilla extract
1/4 tsp salt
In a sauce pan heat Balsamic vinegar until reduced by half and is a thick syrup.  Add the rest of ingredients and simmer over medium heat for 5-10 minutes. Remove pan from heat and use an immersion blender to puree some of the sauce.  The texture is to your liking, so puree as much or as little as you would like.  Store in a sealed container for up to a week or you can freeze it for long term  storage. This site also has a almond milk Panna Cotta but this is not the recipe use at the group meeting.

Panna Cotta Recipe
1/2 C 2% milk mix with 2 1/2 tsp of unflavored gelatin in a bowl to rehydrate the gelatin let sit for 5-10 minutes

In a medium saucepan mix
3 C 2% milk or whole milk
one vanilla bean split in half or 1 tsp vanilla extract
2 TBSP maple syrup
1 tsp salt
heat until steaming but not boiling, about 5-7 minutes.  Take off heat.

Mix 1/4C greek style yogurt into the milk and rehydrated gelatin. Then whisk about 1 C of hot milk mixture into the gelatin/milk. Add this mixture into pan of hot milk and whisk well.  Pour hot Panna Cotta mixture into ramekins.  Refrigerate until set, about 2 hours.

In a small frying pan toast 2 TBSP Flax seed and mix with 2 TBSP hemp hulls. Before serving top with Strawberry  Balsamic Compote and flax seed/hemp seed mixture to your taste.

Leave a Reply

Your email address will not be published. Required fields are marked *