I am currently looking for software that can accurately provide bilingual subtitles. In the meantime, I will post the English translation of the video transcript in the pinned comment to help friends outside the Chinese-speaking world understand the content of the video. Thank you again for your support and for watching. 給需要雙語字幕的朋友:很抱歉,目前正在尋找能夠更精確上雙語字幕的軟體,在那之前我會把影片字幕逐字稿的英文翻譯放在置頂留言,方便中文世界以外的朋友理解影片的內容。再次感謝大家的支持跟收看。 The term "sunshine vitamin" is a magical nickname for vitamin D. When your skin is exposed to ultraviolet rays from the sun, cholesterol (7-DHC) under the skin undergoes a photochemical reaction, transforming into vitamin D3. D3 is then activated in the liver and kidneys in two stages, eventually becoming calcitriol, or active vitamin D. Generally, 20 minutes of sun exposure daily is enough to produce the vitamin D your body needs. However, due to reduced outdoor activity and heavy use of sunscreen in modern times, the vitamin D produced from sunlight is becoming insufficient. Furthermore, vitamin D deficiency is more common in people who are obese or have chronic illnesses. Many chronic conditions can affect vitamin D synthesis and accelerate its depletion. Therefore, in cases of insufficient sun exposure, it is still important to supplement vitamin D through diet or supplements. Vitamin D deficiency has significant health impacts. Low levels of vitamin D in the blood can lead to conditions such as hypertension, cardiovascular disease, autoimmune diseases, and most critically, various cancers. For cancer patients, vitamin D deficiency can lead to disease recurrence and reduced survival time. Thus, it is crucial for cancer patients to get adequate sun exposure and take vitamin D supplements to maintain blood levels of vitamin D above 30 ng/ml over the long term. This approach can improve their chances of fighting cancer. However, there is a problem with vitamin D supplements: the relationship between dosage and blood concentration is not linear. Clinically, we often see patients who take high doses of vitamin D, such as 5000 or even 10,000 IU daily, yet their blood levels remain below half the normal value of 30 ng/ml. So, don’t assume that taking supplements alone is sufficient. If you can't frequently check your vitamin D levels through blood tests, it's important to be aware of key symptoms of vitamin D deficiency. These symptoms are varied and can often be mistaken for other issues. Today, I'll discuss seven symptoms you should not ignore, as they might indicate a vitamin D deficiency and prompt you to seek further evaluation from a doctor. 1. Bone Pain: Vitamin D deficiency-related bone pain commonly occurs in the lower back, hips, and legs. Patients might experience aching in their back and thighs while sleeping, making it difficult to get up. During the day, back pain can make it hard to stand from a chair, and severe cases can make walking difficult. I once had a patient, a slim young woman, who had pain in her sternum, the bone in the center of the chest that connects with the ribs. Her pain extended to the bottom of the sternum, known as the xiphoid process. She often pressed on it, causing redness and swelling in the surrounding skin, and came in worried about a possible tumor. However, the issue was simply her xiphoid process, and her vitamin D level was found to be only 6. Bone pain from vitamin D deficiency has a unique characteristic: pain relief medications often do not help, and it may be mistakenly diagnosed as a spinal issue leading to unnecessary surgery. This pain is primarily due to widespread inflammation caused by vitamin D deficiency, similar to autoimmune diseases like rheumatoid arthritis. To truly control autoimmune diseases, medications targeting the immune system are necessary, rather than just symptom control with anti-inflammatory drugs. 2. Unusual Fractures: Vitamin D is essential for calcium absorption, and a deficiency can lead to osteoporosis, causing fractures from minor accidents that normally shouldn't result in broken bones, known as osteoporotic fractures. These include wrist fractures from a fall, hip fractures, vertebral compression fractures from lifting, or fractures in large bones like the femur or humerus. Osteoporosis is more common in postmenopausal women and the elderly. If you fall outside these high-risk groups but experience such fractures, you should evaluate your vitamin D levels. 3. Persistent Fatigue: Many people with vitamin D deficiency report an unusual and persistent feeling of fatigue that doesn't improve with rest. They often feel they haven't slept well and lack energy throughout the day, impacting their work and daily life. This fatigue can be accompanied by difficulty concentrating and staying alert. One explanation for fatigue due to vitamin D deficiency is its role in stimulating brain cells that produce dopamine and serotonin. Dopamine helps with alertness and focus, while serotonin stabilizes mood, reducing insomnia and anxiety. This might explain why fatigue from vitamin D deficiency often comes with anxiety and insomnia, making it difficult for the body to get adequate rest. Research shows that supplementing vitamin D can significantly improve severe fatigue and sleep problems. However, fatigue can result from many serious conditions, so persistent, abnormal fatigue should be evaluated by a doctor. Vitamin D deficiency is just one possible cause. 4. Sensory Abnormalities: Vitamin D plays a key role in peripheral nerve function, which involves sensing external temperature, pressure, touch, pain, and proprioception. Deficiency can cause disruptions in these senses, such as feeling tingling without external harm, or having a numb sensation despite touching something. If you experience such sensory abnormalities, consider vitamin D deficiency as a possible cause. 5. Muscle Abnormalities: This includes frequent cramps, muscle pain, abnormal tremors, and muscle weakness. Muscle tremors from vitamin D deficiency often occur in the legs, fingers, or eyelids, and can be severe enough to affect social interactions. A key reason for muscle issues due to low vitamin D is that the body struggles to absorb calcium from the intestines, leading to low blood calcium levels (hypocalcemia). This causes nerves to be unstable, a condition known as depolarization. Depolarization leads to increased nerve signals that trigger muscle contractions, causing cramps, pain, and tremors. If you have muscle problems, it's essential to consult a doctor for evaluation, as vitamin D deficiency is just one potential cause among other serious neuromuscular issues. 6. Increased Susceptibility to Infections: Vitamin D is crucial for building our immune system. It helps stimulate and regulate immune cells to fight harmful microorganisms and cancer cells. During the COVID-19 pandemic, studies found that low vitamin D levels before diagnosis were associated with higher risks of severe COVID-19 and complications such as long COVID. If you suddenly find yourself frequently getting infections, such as colds, urinary tract infections, or cold sores, it might indicate low vitamin D levels and warrant further testing. 7. Excessive Sweating: People with vitamin D deficiency may experience severe night sweats, making pillows and sheets soaked. They might also sweat excessively during the day in areas like the forehead and back of the neck, regardless of the weather, exercise, or body temperature. The cause is linked to low blood calcium levels due to vitamin D deficiency. Calcium stabilizes nerves and prevents excessive depolarization, which leads to sweating. If you have excessive sweating, consider vitamin D deficiency as one of the potential causes. Identifying vitamin D deficiency is simple with a blood test. The challenge lies in recognizing the potential for deficiency and acting promptly. Many of the symptoms can improve with vitamin D supplementation. Correcting a vitamin D deficiency early can enhance quality of life and prevent more severe chronic diseases, including cancer. After watching this, keep an eye on these symptoms and consult a doctor if necessary.