Search for tag: "deficiency"

Interviewer: Your partner is suddenly not interested in sex anymore. Something is wrong, but you don't know what. Is this normal? We'll find out next on The Scope.

Announcer: Questions every woman wonders about her health, body, and mind. This is, "Am I normal?" on The Scope.

Interviewer: We're talking today with Dr. Kirtly Parker Jones. She is our expert on all things women. And, Doctor Jones, we got an email today from one of our listeners and she asked, her husband or her boyfriend, she just said partner isn't feeling anymore for sex. He's not interested. She knows she is normal, but is he normal?

Dr. Jones: Okay, as a woman gynecologist, I'm not sure about my standing here on this guy thing, but as a reproductive endocrinologist, a specialist in infertility and hormone problems, the issue comes up in my practice. So let's get to the "is he normal" part. Remember, we talk about "not normal" as being what is experienced by less than 5% of people. Not normal is sort of like not very common. Women and men have the unrealistic expectation that when it comes to sex, men are always ready, willing and able, but population studies suggest that about 20-25% of men said that they are not interested in sex at some times. And that would make your man normal, meaning lack of interest in sex is common.

Now, lack of interest is more common in women than men, with about 40% of American women saying in the past year there was a period of at least two weeks when they weren't interested in sex. Now, when it comes to men and women, there is no normal when it comes to the frequency or interest, as the range is all over the map. So we can use a decrease in interest or libido as a decrease in what the man had experienced before. So the causes of decreased libido in men are largely the same as in women. And let's go through some of those.

One, lack of novelty. The frequency of sex is more a function of age of the relationship than the age of the partner; everyone knows that. Newlyweds or new relationships are run more hot than long-term relationships.

Number two, stress. For men and for women, the stresses of daily life cloud the brain and you have to have a pretty empty brain to be completely focused on sex. Depression is also common in men and women and can be a major suppressor of sexual interest.

Three, partner conflicts. Women can be pretty verbally judgmental of their partners. And an unsupportive relationship is a turn-off. If your partner is angry with you, he might be less interested.

Four, lack of sleep and kids. And they go together. Having a bunch of kids in the house, particularly young ones, can preoccupy both men and women.

Number five, poor body image. Women understand this, but men can be affected by body image issues that make them feel somewhat insecure. Yes, guys can be insecure and that may decrease their interest.

Number six, alcohol use and abuse or drug use and abuse. A little may be a relaxer in the alcohol field, but more than a little on a regular basis will turn off desire for women and men.

Number seven, medical problems and medications. Interest flags when someone isn't feeling well and some medications are directly affecting libido, such as some blood pressure medications and some ant-depressions.

And number eight, then one all women assume first and worry about the most, infidelity. Is he getting his sexual needs met elsewhere, either in reality or in virtual reality?

Interviewer: So those are the things unique to women. How about men, do they have anything unique to them?

Dr. Jones: Oh, yeah! One that affects men and women is sleep apnea, but it's more common in men than women and it can lower testosterone. And it's compounded by obesity. Second is erectile dysfunction. Women tend not to have that problem. If a man's had problems with erectile less function, it can lead to concerns about the ready, willing, and able part and make men more reluctant to initiate sex. Three, aging. Aging alone in men can decrease libido and testosterone.

Interviewer: But they don't have what many women have. They don't have menopause, right?

Dr. Jones: Well, there is something out there called andropause. Now, it's not an acute event like menopause. It's more a decline in androgens. And a decline in androgens with aging is normal, but there is this whole thing about anti-aging therapy that some clinicians out there in practice, practice medicine that is not exactly traditional medicine, where they try to "normalize" levels of hormones, including testosterone, to the level of a 20-year old, even though you're 70. Now, whether that is wise or not is another issue.

But testosterone deficiency actually isn't very common. The normal range for testosterone is large and men at the lower end of the range can have normal libido. Remember, when it comes to sex, normal is just another setting on the dryer so it's hard to talk about normal. But testosterone deficiency is not nearly as common as advertisements would make it out to be and not nearly as common as prescriptions for testosterone would indicate.

Now, they are chronic medical conditions and obesity and sleep apnea and aging that can lower testosterone, but only a few men actually have this testosterone deficiency. However, testosterone is a medical problem and can have the side effects of other medical problems. It's worth getting a test if a guy brings it up with their health care provider. By the way, a good clinician asks questions about sex as a routine part of healthcare.

Interviewer: So what's a girl to do? What's her option here?

Dr. Jones: Well, it's a touchy subject and a male partner might not want to talk about it with you or his guy friends. Being supportive in a relationship is always important unless there are some behaviors like alcohol or drug abuse that can't be supported.

Ask him if he's feeling okay these days. Tell him you miss your closeness in bed. Is he sad or mad? Does he have new worries or concerns you might help with? If he's having a sexual side effect of a new medication, ask him if he wants to talk to his doctor about it. If he isn't feeling well, has gained or lost weight, is snoring a lot, maybe he want to see his primary care provider and have a discussion. It's a difficult discussion, but be brave. Even if you might not like the answers, if this is an important relationship to you, and you care about this person, it's worth the effort.

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Dr. Gellner: You've got a picky eater at home, and he's acting a little weak or he looks pale to you. Could he be anemic? I'm Dr. Cindy Gellner and today we're talking about iron deficiency anemia on the scope.

Announcer: Medical News and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Dr. Gellner: Often I get asked to check a child for anemia because they look pale to a parent, they have dark circles under their eyes, or someone in the family currently has anemia and a parent thinks the child has it too. Luckily, iron deficiency anemia is not as common as one would think. So what is iron deficiency anemia? Anemia means that the number of red blood cells in your child's body is below normal. The red blood cells carry oxygen in the blood stream and iron is needed for your child's body to produce those red blood cells.

Iron is also needed just for your child to grow and develop. Iron deficiency anemia is caused by a child not getting enough iron in his or her diet and the peak age for iron deficiency anemia is one to three years in toddlers. Anemia is diagnosed with a simple blood test and we routinely do this blood work at the 12 month well child visit. That is when most times we find iron deficiency anemia.

Toddlers are picky eaters which is why that is also a big risk group for iron deficiency anemia. Iron deficiency anemia is more often found in solely breastfed babies as breast milk does not contain iron like formula does. For this reason, we often recommend that babies only given breast milk take an iron supplement while nursing.

So if your child is found to be anemic, how can you help them? Most likely they will need to take an iron supplement prescribed by your pediatrician and will need to take that for two to three months in order to get their red blood cells back to a normal level. It can cause an upset stomach, and it should be taken with food to prevent this.

Also, you want to take iron medicine with a juice containing vitamin C, specifically orange juice works great. This will improve the iron absorption and prevent the staining of the teeth. Iron supplements are very smelly and they are black and they will stain anything they come in contact with so be careful when you're using iron drops. Do not give iron with milk or formula because the calcium in the milk competes with the iron and it reduces the absorption of the iron. The iron may also change the color of the bowel movements to like a greenish black and kind of sticky and stinky, but this is normal and harmless.

One thing to be concerned about is that too much iron can be dangerous and can cause poisoning. So you want to make sure to keep all iron supplements, just like any other medication, out of a child's reach. Do not give your child iron supplements unless your child has been diagnosed with iron deficiency anemia by your pediatrician. Again, too much iron can poison a child.

So what if your child is not anemic, or you're worried they're going to be just a little bit anemic, or the blood tests show they have some anemia but not so much you need to use the drops. What do you do? The good news is a simple well balanced diet will help prevent anemia. Meats, fish, and poultry have iron that's more easily absorbed than iron from plant sources. Raisins, dried fruits, sweet potatoes, kidney beans, pinto beans, peas, peanut butters, and especially cereals and breads are all fortified with iron. Cheerios is a favorite fortified cereal for toddlers. So I often recommend cheerios.

Another way to prevent iron deficiency anemia is to limit your child's intake of milk. Again, milk and iron compete in your child's body. So your child should not drink more than 24 ounces of milk a day. Your pediatrician will recheck your child's blood work in three months if they've needed to start the iron supplements or they've just got the mild anemia to see how much the anemia has improved. If your child's anemia has completely resolved, there's no need for any further treatment. If your child's anemia has not resolved, your pediatrician will come up with a plan on how to help your child, figure out the cause of anemia, and treat it.

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Interviewer: Can a little bit of light make a difference in your health and mood in the wintertime? Should you get outside, get some light? We shed some light on that next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: We're talking with Dr. Kirtly Parker Jones about sunlight in the winter time, more specifically Vitamin D deficiency, and there's a lot of kind of side effects that come from not getting enough Vitamin D or enough sunlight, is that the case and could you tell me what some of those are?

Dr. Kirtly Parker Jones: Okay, well first of all you have to remember we evolved, all species, animal species, in sunlight. And there are some really important things that sunlight does. Number one, it sets our clock and particularly those of us in northern climates, it's curious to me that we have higher rates of suicide then southern climates, it's not just because people in the Mediterranean drink a lot of booze and hang out and do nothing. We've always know that people get more depressed and do less when there isn't much sunshine. So you need to set your clock and sunlight sets your clock and your activity. So people who get out in the sun feel a little bit more active.
Number two, our skin is our own vitamin D manufacturer. So it's the combination of sunlight on skin that helps us make vitamin D. So what should we be doing? I think everybody, except maybe on a red air day, or even on a red air day, you don't have to run around, needs to get out in the sunshine. Get your face, if you can, if it's not too cold, get your arms out in a little sun, it doesn't take very much. Get some sun on your eyeballs and get some sun on your skin, only 20 minutes can make a big difference in your mood, in your activity, in your sleep and in your bones.

Interviewer: Is the type of vitamin D that your skin is making and that your eyeballs are making better than the type that you get in your food, for mood and those types of things?

Dr. Kirtly Parker Jones: Well certainly it's more readily available and more bio-active and that's important. Actually it's harder for your skin to make vitamin D when you get older and you still need it. So I think there are good reasons to take vitamin D supplements. But a small amount of sun, particularly in the morning, can set your clock, make you feel better. Move around a little bit and get a little bit of some vitamin D and I hope my best friend who is a dermatologist doesn't hear me say this.

Interviewer: Tell me about the light box you have over there, what does that do? Is that to mimic the sun?

Dr. Kirtly Parker Jones: Yes, it is. So a light box gives full spectrum light to your eyeballs, it's not going to burn my skin, it doesn't have any UV in it, so it doesn't take much, half an hour is enough to help set your clock.

Interviewer: I have a friend that in the winter time, she gets very moody, somewhat depressed and as a result goes to Hawaii for a couple weeks in January.

Dr. Kirtly Parker Jones: You could buy a lot of light boxes for a trip to Hawaii, so I'm a big fan of the trip to Hawaii.

Interviewer: Is that why, she's not getting enough sun or does she have something that's different?

Dr. Kirtly Parker Jones: Yes, seasonal affective disorder is something that we see in northern climates as the days get shorter and the morning light is less remarkable and people don't get out in the sun. So the best thing for people with seasonal affective disorder is to get out in the sun. People are sensitive to low light and little light and shorter light, and if you are, sure go to Hawaii if that makes you happy, but if you don't have the money to go to Hawaii, you need to get a full spectrum bright light, and light boxes are relatively cheap and you can do that.

Interviewer: And then to get out in the sun, just go sit in your car for 20 minutes?

Dr. Kirtly Parker Jones: I wouldn't sit in your car, its better if you get yourself wrapped up, and besides, the sun can't get into your car anyway, what you want. So get yourself wrapped up and get some sunlight on your eyeballs and when you get warm enough because you've walked around, just push your sleeves up and get some sun on your arms.

Interviewer: Is it safe to say 20 minutes of sun can really change your mood in the winter time?

Dr. Kirtly Parker Jones: I bet you if I went and looked at the research that 20 minutes to an hour is recommended for people with seasonal affective disorder and even those of us who don't have seasonal affective disorder, you know how you feel, as a Utahan in particular when we have a week when there's no sun, people get crabby. So go find some sun and it's often not that far, it's not as far as you think, if you put your snowshoes on or go for a walk. So go for a walk or, and getting some bright light in your eyeballs. The sun is important to us.

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