Category Archives: Education

Vitamin D and the Foot

Vitamin D and the Foot

I have been doing my weekly update on research and views for a few years now and you start to see patterns in the research and the literature. One that really stood out like a sore thumb was vitamin D. At one stage a year or so ago, I was commenting at least weekly on something to do with vitamin D and the foot. I even got feedback that I was some sort of vitamin D junkie (I’m not). More lately its probably once a month or so, but that is still a lot compared with other topics. Its hard not to miss how much research has been regularly and recently added to the threads on Podiatry Arena on vitamin D and the diabetic foot and the thread on vitamin D and foot and ankle injuries. With that sheer volume of content and research one can not help but think that it might be important and relevant.

What is obvious from all that research is the frequent correlation between lower levels or a deficiency of vitamin D and wide range of foot and ankle problems (from diabetic foot ulcers to stress fractures to muscle strains to the outcome of trauma etc). There are strong correlations between low vitamin D and a whole range of general medical conditions. Even more recent is all the research showing strong correlations between getting COVID-19, the seriousness of COVID-19, the outcomes of COVID-19 and vitamin D.

It is from there that there is a divergence between the science and the pseudoscience. The research has clearly and strongly demonstrated the correlation with low vitamin D and a whole lot of problems. We all know that correlation is not causation, but those promoting pseudoscience or selling vitamins do not get or understand the difference. That science is generally not so strong on the causation which has not stopped the cranks promoting the pseudoscience. There is generally very little evidence that prospectively links vitamin D to a higher risk of problems. There is also limited research showing that taking vitamin D fixes the problems that a deficiency is correlated to. That general lack of prospective evidence does not mean that vitamin D is not important, it just means that we need to be cautious about claims made for it and that context needs to be acknowledged.

Of course, generally, if someone is deficient in vitamin D, they probably should be taking supplements to get that up to normal. What should not be done is promoting vitamin D as a treatment if vitamin D levels are normal. Take any more than the required amount and the body just tries to excrete it. Vitamin D toxicity from over-supplementation (rather than an overdose of sun) is a thing and carries risks.

The COVID-19 case is an interesting one to observe. I have seen vitamin D supplements advocated to help prevent catching the coronavirus, probably from those selling vitamin D. There is no evidence that will work, despite the high correlation between COVID-19 and the vitamin D deficiency. Of course those sick with COVID-19 and are deficient should be given supplements as it just makes sense. The line has to be drawn at claiming vitamin D as a treatment for it, which certainly has not stopped the cranks with no experience in treating COVID-19 from claiming. While, I have doubts that this is the case, but it could well be that COVID-19 increases the demand for vitamin D, so the infection causes the deficiency rather than the other way around. These types of conclusions or hypotheses can not be made or excluded based on the current state of the science.

This area also attracts more than its fair share of clueless cranks, especially those who talk about vitamins boosting the immune system. If you hear anyone talking about that, stop listening or (preferably) call them out for their dribble. The last thing I want to do is boost my immune system.

Yes, vitamin D is important for foot and ankle problems; and yes, getting out in the sun and taking supplements is important. Just stop listening to the cranks. The buzz about vitamin D is overblown.

Disclaimer: I take a low dose of vitamin D as I have one of the conditions that correlates to low levels of vitamin D.

Postscript:
The issue is so important that we did a PodChatLive on it with Farrah Jawad.

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Why Podiatrists Should be Concerned About Concussion in Sport

Concussions have always had a particular interest for me. The politics around concussion in sport and the alleged cover-ups and the significant public health consequences have long been a fascinating issue to follow. Will Smith’s 2015 movie, Concussion and the 2013 book, League of Denial highlighted just how political and controversial it has become. Who remembers or knows what the Lonergan Shuffle is?

Why should Podiatrists be concerned about concussions?

  1. Concussion in sport is a major public health issue, with significant long term societal and personal health and mental health effects. All health professionals should be concerned about and be proactive in all public health issues and educating the community about the issues and advocating for those issues. Smoking and obesity are other public health issues.
  2. There is a significantly increased risk for lower limb injury following a concussion and that risk can last for at least a year or so. There is a very large number of studies that have shown that. You can follow this thread which lists all those studies: Concussion and the lower limb and as a public health issue
  3. We are parents, we are members of the community; our kids are involved in community sport. We could be the first responder to a head injury in the community, especially at our kid’s sport.

On the third point above, I had a daughter who spent a few years playing full-contact rugby in a boys’ team. By default, I became the de facto ‘team doctor’. I freaked out every time one of the boys (or girl) went down with a potential head injury – mainly because I knew the consequences of a concussion. I always acted quickly and made sure play was halted until I took an appropriate action for a sideline HIA (Head Injury Assessment) and ruled out other trauma and then made the call to escalate or continue play, following appropriate guidelines. Luckily, they were a tough bunch and I never had to deal with one that was a concussion. Yes, I know my lane and I stay in it; but I am also a member of the community and in the context of the lack of other appropriate or more qualified cover, I was the first responder. We are required by Podiatry Board of Australia to be re-certified regularly in first aid. There is a reason for that.

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Postscript:
No sooner than I write the above, this study appears showing that those who have a time loss lower limb injury are more likely to go on and get a concussion.

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  • English (Publication Language)
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  • Manufactured from High Quality Medical Grade Stainless Steel
  • Nail Cleaning and Care Instruments
SaleBestseller No. 3
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  • Hardcover Book
  • English (Publication Language)
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  • Used in electric nail drill machine for manicure and pedicure
  • NON ABRASIVE NON PAINFUL cuticle and callous treatment
Bestseller No. 7
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  • G.S INSTRUMENTS ARE JUST SOLD BY G.S ONLINE STORE.
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Bestseller No. 9
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  • Interactive location map
  • Schedule Appointments
Bestseller No. 10
Profoot Chiropody Felt - Chiropody Padding - Podiatry - Pack of 2
  • Profoot Chiropody felt is ideal for bunions, blisters, calluses and foot discomfort
  • Self-adhesive padding for foot pain due to pressure and friction. Adhesive backing can be stuck to shoe or foot

I get commissions for purchases made through links on this website. As an Amazon Associate I earn from qualifying purchases