#vitamin d deficiency signs

[liferede]

The Impact of Vitamin D Deficiency on Your Health

[skintreatmentinindia]

Vitamin D For Skin Health-What Expert Says

Every day, we face the dilemma of getting older. As a result, prevention of the skin from harmful UV rays and finding the root cause of skin damage starts. Vitamin D is a primary factor that leads to skin issues. How vital Vitamin D is for healthier skin, this blog has been prepared. 

We consulted Dr. Ravali Yalamanchili, a dermatologist practising at Neya Dermatology & Aesthetics Clinic, the best skin clinic in Hyderabad. To learn all about vitamin D, going through this blog and learning about the potential side effects of a lack on the skin will be beneficial.

What is Vitamin D?

Essential for many bodily processes, vitamin D is a fat-soluble vitamin. When exposed to ultraviolet light, the skin begins to synthesise it, making it a vital natural reservoir for this substance.

Low levels of vitamin D

The amount of vitamin D that can be obtained from sun exposure alone. It depends on a number of things. A lower level of vitamin D absorption from sun exposure may exist if you-

wear sunscreen 

residing in a highly polluted area

Occupy most of your time within skin colour (a higher melanin level means your skin can't absorb as much vitamin D)

If you reside in a city where buildings screen the sun

Vitamin D deficiency can be more likely if you have certain conditions. That's why it's wise to supplement your vitamin D intake with foods and drinks.

Signs & Symptoms of Vitamin D Deficiency 

In adults, a vitamin D insufficiency can manifest as

Exhaustion

Muscular discomfort,

Serious aches and pains in the muscles and bones, particularly in the lower extremities, pelvis, and hips 

stress 

fractures

A vitamin D deficiency can be diagnosed with a simple blood test. In order to assess the severity of a deficit, your skin doctor may recommend X-rays of your bones.

Vitamin D Rich Food 

Vitamin D is found naturally in some foods and is added to others through fortification. The following foods contain vitamin D, 

Fish, Shellfish

Tinned Tuna, Sardines, And Herring

Liver Oil From Cod

Meat, Liver, Shrimp, Egg Yolk

An assortment of fortified grains and oats

Yoghurt with added nutrients 

Fortified orange juice

Supplements of vitamin D are an option because it might be challenging to acquire the recommended daily intake from food and sun exposure alone.

The bottom line

Vitamin D may have numerous positive effects. Some studies have shown that it can lower the risk of certain diseases, boost mood, alleviate depressive symptoms, and aid in weight management. Get a blood test and think about taking a vitamin D supplement if you're not getting enough vitamin D from food alone. In case to learn more about vitamin D or the treatment for skin disease you can visit Neya Dermatology Aesthetics Clinic. This clinic offers consultation and effective skincare treatments from the best dermatologist in Hyderabad, Dr. Ravali Yalamanchili. To learn more, visit now!

Original Source:- https://scoopearth.co/health-2/vitamin-d-for-skin-health-what-expert-says/

[the-ellia-west]

No literally

Legitimately

I know you've heard it a million times

But Touch Grass

Drink Water

The main factor of skin issues, mental issues, and most importantly WRITERS BLOCK AND MOTIVATION

Comes from Vitamin D deficiency and Dehydration

I STARTED DRINKING MORE WATER AND GOING OUTSIDE MORE AND MY MOTIVATION SHOT THROUGH THE ROOF

DO IT

IF YOU DON'T BELIEVE IT, EXPERIMENT ON YOURSELF

Trust me it's awesome

Happy Mothers day

Signed: Your new caretaker/Mother figure if I have to be

Go drink water I'm serious

@starmanbutitsregulusblack @crushedmodule @sunglasses-in-the-bentley @aesthetic-writer18

[theglamorousferal]

Jazz Fenton is the first person born liminal enough for a proto-core since the fall of a previous dimension.

She was also born with the hyperfocus and scientific mind of both her parents and so, after realizing this, she began documenting her findings.

After she took the title of Queen Regent and pulled the entire town into the Ghost Zone, effectively cutting the GIW off from the dimension entirely, the research took on a new meaning. It turns out that any child born in the town limits since the formation of the portal was liminal enough to form a proto-core. Any child born after was sure to show signs of liminality at younger and younger ages.

Her research becomes a guide to the entire town of Amity Park as their exposure to ectoplasm slowly turns them more and more liminal.

After everyone settled and rebuilt, she had time to explore her newfound power. Taking the Ring and the Crown had led to her proto-core forming an aspect. At first she believes she had light, or perhaps fire. Until the town started to notice they were getting more and more depressed.

After testing, they find everyone who is a liminal human is suffering from vitamin d deficiencies.

After consulting with her mentor Pandora, she finds she has a sun core. She is able to have a localized sun over Amity as it is her Haunt. This ends up extending out to the rest of the Realms and now it's warm in the general vicinity of the Keep and Amity.

Plant-loving ghosts post up their haunts nearby.

Dhul-Ahman's Domain moves closer as well.

That's some stories for another time though.

[whispersofmercury]

Sun in the 6th House

*or Leo ruling the 6th house

Personality

☀️ These people need meaningful work to feel fulfilled in life! They need to feel useful or of service to others or something may feel missing in their lives

⚕️Health could be a big theme or part of these people's lives! For example they may become Healthcare workers, or maybe they have some health issues, or maybe they are just very interested in health!

☀️ These people are usually hard workers (depending on sign and aspects). They are generous with their time and energy too!

⚕️Excellent in leadership! Especially middle management positions where they are not the leader of the whole thing and still in service to someone else, but also utilizing their excellent organization and management skills

☀️ As a warning, these placements can take on others' work and do everything for them! Make sure people are not just taking advantage of you! These people might also have a hard time delegating tasks to others

Health

⚕️The sun represents the overall vitality of a person, the heart especially and also the circulatory system so with the sun in the 6th these things are very important to your health!

☀️ Health issues can arise from doing too much for others!

⚕️ With the sun in the 6th house specifically, it's really important to get enough sun and vitamin D. While this is important for everyone, these people can feel vitamin D deficiency more prominently!

☀️ Also, make sure to keep an eye on your heart, circulatory system, and all that because the sun ruled areas might be more vulnerable to health issues! Since the sun rules the back, also be aware of potential back pain! (Some type of stretching or exercise routine might be beneficial here, too!)

*A lot of information of this post came from my notes from Astrology with Heather! I adore her channel, and if you liked this post, I'd highly recommend you check her out!*

[sincerelywhistler]

You are my Sunshine☀️

How vitamin D deficient do you think they really are after livin in Blake’s Boyfailure Mancave for that long

More headcanons (ft. Elliott) under the cut!

(Soleil is pronounced as “so lay” btw, meaning sun)

• Sunshine and Elliott are the Sweet Dorky Nerd x Punk Just As Dorky Rascal dynamic in my head

• Academic try-hard, but in a non-toxic way so they don’t bite off more than they can chew. They know their limits and follow the rules

• Going back for their masters degree in bioengineering after taking time off to mentally and physically heal from the car crash

• [Bisexual Panic]

• You cannot hang if you don’t rock out to the radio in the car with them

• ORGANIZED. Everything must be organized or they can NOT function properly. Elliott was a bit of a messy guy before they taught him better

• 😁 is their most used emoji

• Has a white fluffy cat, Serafina, named after the cat in the Barbie princess and the pauper movie bc it was their comfort movie growing up

• Elliott refers to the cat rarely by her name, but as “my lady” and “your highness” because she’s clearly house royalty

• Eli and Sunshine go to weekly trivia nights hosted by the local diner for date night and they get so sweaty about it. Friendly competition

• Drives a Miata hehe

• Laughs a lot, and they always tip their head back when they do

• Always throwing up a peace sign in their group pictures

• Had to get a cochlear implant as a result of their car accident

• Hand makes *every* birthday card with the prettiest stationary

• Soft and sweet appearance, but don’t be fooled because they’ll read you for filth if you get on their bad side

• Clingy partner, but Elliott certainly doesn’t complain because he’s just as bad

• Great listener who gives great advice

• Family is from India, their grandparents being the first to move to the US

• Their family is mostly Hindi speaking, so sunshine is fluent. Eli loves to learn new Hindi words and phrases and surprise his partner with them

• Ambivert

• Elliott gifted them their sunshine necklace and they wouldn’t be caught DEAD without it

• A little bit of optimism can go a long way; they’re the first one to keep their chin up when things get rough

[madamlaydebug]

☀️Sunlight is essential for all life and growth. Make sure to spend time in the sun daily! If you live in area with only little sunlight, regular use of solarium provides some of the benefits.

. . .

⚠️Conventional suncreams are highly dangerous and should not be used in any situation. If your skin is not used to sun, use long sleeved clothes and 100% natural, organic suncream with physical protection (not a product with absorbable mineral particles and chemicals), until it is. Once the skin is used to sun, no need to put any suncreams on. Avoid burning yourself.

. . .

💊Even if you get sunlight daily, strong vitamin D supplement is needed. All around the 🌎. Foods don't contain enough vitamin D. Optimal daily intake is way more than is commonly recommended. Good amount of vitamin D in blood is 100-150 nmol/l.

. . .

⚠️If you get sunburnt easily, that is a sign of vitamin and mineral deficiencies!

. . .

🕵️‍♀️Research also the health benefits of sungazing, the dangers of chemtrails ✈️ and the harmful effects of sunglasses 🕶!

. . .

💛Sharing is caring. Tag a friend!

[identitty-dickruption]

how I acquired testosterone

caveat: I live in Australia, in a place that uses an informed consent model. this is probably different in different places with different laws 👍

FIRST: I went to my local queer community charity to talk to them about what getting T would look like in my area. they were able to recommend a GP who was unlikely to be weird about gender

SECOND: I had an appointment with that GP. he asked me:

my family + medical history

my psychiatric history

about the nature of my gender dysphoria

he then gave me a referral to my local sexual health clinic + sent me off to get a blood test. the blood test was all the normal ones (iron levels, vitamin levels) and specifically hormone-related ones

THIRD: I had an appointment with one of the endocrinologists at the sexual health clinic. she asked me about:

dysphoria

gender euphoria

my sexual history

she then told me every single possible thing that could go wrong if I took T, as well as everything that could go right. she gave me the expected timelines for transition depending on the T dosage + method

FOURTH: I had to wait (minimum) one month. during this time I had more information to read about T, some more questionnaires to do, and some forms to sign. the waiting period is part of the informed consent model (they want you to sit and think about the pros and cons of hormones before taking them)

FIFTH: I had another round of blood tests during the month-long waiting period. this is because my GP didn’t prescribe one of the ones he was supposed to and also because the endocrinologist wanted me to get checked for various STDs

SIXTH: I had my second appointment with the endocrinologist. she weighed me, checked my height, and double-checked my bloods. she asked me what I’d decided I wanted (low dose of T gel). she prescribed it!

SEVENTH: I went to a pharmacy to get my first script :D my endocrinologist put it in the system as a “testicular deficiency” so that I could get it on the PBS scheme. this means it costs about $35 for four months worth of testosterone

and that’s it! I have to get blood tests every two months for the first couple years, but then it’ll only be an appointment to renew the script. none of it is as scary as it seems, I promise. they make it very easy to opt out if you change your mind at any point. but I cannot emphasise how much I recommend giving it a go if you’re curious about it

[unikivrse]

my christmas spirit

୨˚̣̣̣͙୧ ⋆ 엔하이픈 ( 리키 ) + gnreader!oc (*≧∀≦*) content fluff established relationship slight angst foreign student reader minor kissing warning skinship dragged swearing & 2.1k bookshelf 𖥔 ࣪

🗒 to say i hate this would be an understatement but i hope im just being harsh on myself. anyway hope everyone has a merry ‎christmas :D tysm @nqvgue for helping me get the storyline straight ;-;

The softness of the late December snow was nothing but comfort to the procrastination filled Wednesday evening. Volunteering at the hospital as an apprentice was hectic in the winter. Whether it was because the wards you worked in were jam packed with festive injuries or maybe it was your crippling vitamin D deficiency that kept you from having the energy to work efficiently. All you could do was grasp the warm, hot chocolate mug as you melted into your uniformed legs that were hiked up on the break room sofa, gripping onto the last bits of consciousness you had, blinking profusely to try and stop yourself from passing out.

Lately you have been missing home. Missing that one thing that made you excited for the bitter days at the end of the year. Missing him. You hated getting soppy at work as you normally ended up crying in front of patients but there was something about the holidays that made you even more overwhelmed with appreciation. Riki had been working so hard, attending meeting after meeting, fan sign after video shoot and album signing after performances. You felt bad that YOU were so bothered by his work, by the state he visited you in. Falling into tidied sheets with an untidied attitude or drifting off to sleep whenever you were on call. You wanted to spend Christmas with him but it was like he wasn't there. The guilt of feeling jealous when he spent more time on weverse doing fan service than doing relationship service got too much to the point he snapped in front of you for constantly complaining about his exhausted state. You understood he was tired but you couldn’t help but to envy all the couples doing fun activities whilst you were stuck with dead legs by the weight of your passed out boyfriend's head.

You and Riki never argued. If you did it was always about the most mundane of things like who's turn it was to wash up or what position you were going to sleep in. Never anything serious. Never anything that kept you up at night crying over the look he gave you. You two had been pretty distant for about a week and a half at this point. You never stopped checking in on each other of course, its not like you stopped loving him but there was no effort for a conversation. You thought if you just let him get on with it, his schedule would die down and you'd have the same devilish boyfriend again but nothing came of it. Distracting yourself was the only thing that kept you from panicking as the big day came closer and there was still no sign of improvement. Your friends told you to have some 'christmas spirit' as your mood appeared drained but to be honest it was like Riki was the only Christmas spirit you could focus on. Like a ghost haunting you in the background. Living by yourself in a foreign country at such a young age was pretty difficult especially when all your friends had people to go home to. Riki was all you had and your mind soon filled with the possibility of spending the cold Christmas eve night alone and waking up alone and baking alone. He was never the confrontational type so maybe he was just scared you'd say something and start to pick a fight again?!

"Y/N…” your breath hitched as your senior caught you off-guard. "Hmm?" you squeezed out, trying to locate your voice whilst making eye contact. "You can go home early today" the corners of her mouth slowly turned upwards "I know you've been having a rough time lately, Merry Christmas". Suddenly the heaviness in your eyes released, offering a smile back “Merry Christmas.” You gripped on to the arms of the sofa, slowly lifting yourself to your feet, gathering your belongings.

And just like that, you were rummaging thorough your bag trying to find your schools dorm keys, happy to end the day. Often, days would end with you and Riki curled up in your bed watching horror films or playing animal crossing together but without him, days just merged together and became faint memories. You shakingly opened your door, stumbling as you took off your coat and shoes, discarding your bag and making a run for the kitchen. You don't remember when your fainting spells became so debilitating but you definitely weren't doing well. The shadowed look of your apartment didn't help, resulting in you bumping into cabinets and letting out little ouches along the way. You needed something sugary. Or at least water else you were going to become a pathetic pile on the floor. "Where the fuck-". You were usually pretty good at navigating in the dark but to be honest you weren't doing so well today. You finally let your ego be broken and turned to the light switch in order to fulfill your lightheaded desires. Sighing, you stomped your way over to your sweets cupboard. “Please i will take anything..” you whined, fidgeting around in a spotted tin.

“Ehem.” A deep, raspy voice that didn’t belong to you pierced into your heart, making it drop. You whipped your head around to see your sly, concerned boyfriend staring at you as he leaned against the countertop. “Don’t look so scared” he scoffed, “you look like you’ve just seen a ghost. He approached smirking, but as he got further that smug face he wore dropped, “why do you look like you’ve just seen a ghost? You are so pale!” his hand slid around your waist as he towered over you with concern. “Probably because i was just on the verge of passing out only to be scared by my boyfriend who i haven’t seen in ages. I don’t know just a thought” you squeezed out, gripping onto his biceps as your tunneled vision turned into the outro of the century and your legs began to fold. “Oh my god.. have you been working-” and in that moment, you could no longer hold up the facade of JUST making it back to your dorm, as if the mere touch of him was more than homely to you, allowing you to finally pass out. Right there, in his arms. Obviously you hadn’t put any thought into that. How could you? But seeing you this vulnerable, this fragile broke Riki’s heart in ways he never experienced before.

A subtle mumbling of what seemed to be your television teased your consciousness and senses back into existence, as you soon felt the warmth of your boyfriend’s arms around your torso, hands intertwined in your limp fingers. “Hey, you alright?” he whispered after seeing your newly gained awakening. You couldn’t help but to chuckle a little, after days of not communicating with each other, pondering in the silence that surrounded your relationship, he still spoke to you and held you with the same softness.“I’m sorry”. That’s all you could say. After all the screaming and huffing you shared nights ago all you could do was apologise. He deserved it after all, he had been working hard because this was his dream and you couldn’t help but to be selfish about it. “Me too.” he pouted, leaning into your starstruck face as he did so. “I should’ve spent more time with you and i understand why you were so upset”. Your eyes must of twinkled with the way you were looking at him because before you could even come up with a response to protect his being, he pressed the most gently kiss you ever had on your newly swollen, rested lips. He took his time with it, not pulling back or moving but just enjoying being next to you again. As if it was instinct, your lips turned into a smile and your cheeks became cherry red, you needed to say something, anything, “I guess i just missed you, like a lot and i would have never wanted to make you feel bad about doing your job, especially after working so hard for it but i was just so jealous” you proclaimed after detaching your lips from his. Even the simplest look from his eyes made you feel weary again, as if you were going for round two of passing out. “I guess I missed you too which is why i broke into your apartment to surprise you” he scoffed “but you obviously had other ideas.” Surprise?! “What type of surprise?” you shuffled with excitement, now leaning mostly on him, eyes beaming with curiosity. “Well i was going to do loads of christmas activities with you-” you gasped making him smile, “BUT i thought i’d save that for christmas day and i’ve found something much more worth my time, plus i don’t want you overworking yourself considering the state you’ve gotten yourself into without me” he held your cheek, just staring at you as you repeatedly slapped his arm. Eyes widening you couldn’t help but to screech “TELL ME! TELL ME WHAT IT IS”. It had been a week without anything remotely good occurring and with your overwhelming amount of love for christmas that had been such a letdown, hearing him say that just threw you over the edge as if you were having a psychotic breakthrough. “Hmm i don’t know if i should show you now or laterrr.” he teased, comically scratching his chin whilst turning his attention to the top left corner of your bedroom ceiling. “PLEASE PLEASE PLEASE RIKI” it was so embarrassing how much you needed this right now but you couldn’t help the childish wonders that filled your head. Riki was such a creative gift giver so next thing you knew, you were thinking about him handing you a small teacup sized kitten or relaxing on a white sanded beach together or flipping through a photo album that help all your memories in. “OKAY fine!” he moaned sarcastically, sliding his hand down into his trouser pocket. “Close your eyes and don’t open them until i say you can, even when i start talking.” You nodded, just wanting to find out what it was already. Closing your eyes you heard him clear his throat.

“I don’t know whether you have been feeling the same way i have lately but seeing you so desperate to spend time with me messed me up Y/n. It made me imagine a future where you were tired of waiting up all night for me to wake up or get to yours, a future where you decided enough was enough. I genuinely want you to know i’m here for the long run. Yes, i know we are SO young but i'm not sure i would have gotten so far without you. Which is why i want to promise that i’m gonna stay, that i'm going to try my hardest to show you all the things i think about and tell you how much you mean to me.” You had never heard Riki be so vocal and hearing the desperation and honesty in his words would have made you tear up if your eyes weren’t closed right now. He sniffed. Was he crying? “You can open your eyes now” he whispered. Your eyes automatically searched for his which were now damp and red but you also saw what he was holding. A rose quarts gem mounted on a woven silver band, nestled in the navy velvet box with the words ‘time is only well spent with the promise of you’ engraved into it. To be more than honest, this is not what you were expecting at all. You had never shown any type of materialistic mannerisms to Riki but this was more than that. More then a ring. And with that, you were bawling your eyes out, grasping the very hands that held it. “This is my promise to you. A promise that no matter how far or for how long we are apart from each other, i won’t give up on us.” Lips quivering, you made eye contact with him only to fall into his arms, heart pounding and mouth wailing. You had never felt so hopeful, so grateful. Sure, there was a lot of things you needed to talk about but in this moment of utter emotion, his arms wrapped around you, you felt the warmth of humanity and the passion that came with it. Christmas would soon be even more special as you got to spend it with the most heartful person you could have ever imagined, you were just glad it was him you would be experiencing it with.

taglist OPEN @nqvgue

© unikivrse

[skyloftian-nutcase]

My dumb brain is dreaming about work and now I am trying to convince it to go back to sleep, but this also came to me so… here

If only it was as easy as it was in video games. Wild thought idly as he stirred the scrambled egg and mushroom mix. Mix the correct items together and… poof, instant magic effect. Some days, it would be nice if food could give those who ate it extra energy (maybe Legend wouldn’t be living off ‘comes with a warning label the caffeine content is so high’ drinks), or a boost to their strength (Hyrule routinely stuck manhandling patients twice his size), or… Wild looked towards the stairs, and checked the time both on the kitchen clock and his own watch. They were the same. 12:25. The day shifters were at work, except one. Sky had shown up at Lon Lon two days ago, the signs of an eminent ‘slump’ settling heavily on his shoulders and in his eyes. At least the pilot had been aware of the signs and had come home where there were others to help. But the ‘slump’ meant Sky struggled to get up, to get to work, and in the worst of it, needed prompting to remember basic things like eating. If only there was a magic combination of ingredients to lift the ‘slump’ or better yet, banish it forever.

Alas, the world was not like video games. Best he could do was offer support like a warm breakfast, even if it was well after noon. Wild killed the heat on the stove, moved the pan off the burner, and stuck the lid over top to help trap the remaining heat while he made his way upstairs and to the room that he knew Sky was still in, and probably still asleep.

“Sky?” He knocked on the door, waited for a sound or sign of life, then chanced opening the door. The lump of blankets on the bed moved at his second call.

“Wild?” Sky asked, his voice sleepy and slurry.

“Hey, Sky. I made breakfast.”

The pilot rolled to look at the clock, then groaned as he saw the digits blinking back at him.

“Don’t you have a night shift tonight?”

Wild shrugged. “I can go to bed here in the next hour ish and be fine. I wanted to prep something for the crock pot and that took longer than I expected so… I made breakfast for the two of us.”

Sky sat up, pulling the blanket around his shoulders. “‘Kay. I’m coming…” it would be another several minutes before Sky moved from that spot and actually tried to come downstairs, but it was progress.

“Great. OJ or milk?” He asked as he turned to head back downstairs.

“Milk soun’s good.”

Wild chuckled to himself. That might as well have been a rhetorical question but he still asked.

“K, it’s ready downstairs.”

Maybe he couldn’t magically fix a slump with food, but a warm meal made by a friend certainly helped.

(Fun fact, the things Wild cooks or offers this time are high in vitamin D, or fortified to be so. Some claim that vitamin D deficiency is a part of the seasonals and making sure you have enough can ease depression symptoms, but full disclaimer, not medically or nutritionally trained. Just armed with internet search abilities and enough knowledge to make trouble.)

I love this ❤️❤️❤️❤️❤️❤️ The wishing life was a video game made me smile, adore that, but Wild doing something so simple and impactful just sofuwkwiqwhfid my family does this for me all the time and fufuwworhdiIWWHFKCUAHWOR AHHH 😭😭😭😭😭❤️❤️❤️❤️❤️❤️ Cookijg as a love language is just SO—aahhhh thank you ❤️

[venustalksalot]

Supplements I take and why🎀

Fish oil/omega 3: Keeps skin hydrated and minimises signs of aging (which will be worse for ppl like us) and also helps with my endo

Biotin: SO GOOD FOR YOUR HAIR OMLLLL

Iron: my ass is deficient in it that's why

Vitamin D: I don't go outside a lot... also helps w muscle cramps and spasms!

Calcium: lessened hair breakage for me. Also got told to take it for my bones since I smoke lolsies

[oneshotnewbie]

Is there a tiny little chance that you will update <Missing for a Decade> soon? I absolutely love this idea, and I would love to read more of it!! <33

Supergirl - Missing for a Decade Part 5

Trigger Warning: This one-shot includes the topic of abduction and mentions of abuse. These plots are presented. If this triggers you too easily or you just can´t handle those subjects, I urge you NOT to read this work. I am NOT embellishing this topic under any circumstance. Read at your own risk.

Authors Note: Here you have a new chapter ♥ I'm going to edit the older chapters again since I don't like them and they seem a bit inconsistent when I look at this current chapter

ᕚ---ᕘ

"You came to talk to me about your sister and niece before you take them home?" the older gentleman asked, clearing his throat and turning completely to the women who had entered his office. "Yes,"

"I have treated more than hundred kidnapping victims, but none like your sister. Despite her captivity, she is open to other people and hardly scared which fascinates me. She is very strong," The doctor folded the remaining files on his desk and clasped his hands on the table in front of his torso, fingers locked tightly together. "You know, every victim presents a new challenge and it is like reading a map of battered bodies that have been unjustly violated"

Both Alex and Kara interestingly pulled a chair from the corner and listened to the doctor go into more details about your health, the various tests and examinations that they did on you.

"She is chronically underweight, physically atrophied. She has anemia, vitamin D and iron deficiencies, and some skin lesions and inflammation from the lack of natural light." he unbuttons the cuffs of his shirt sleeves and rolled them up. "Y/n Danvers shows signs of severe violence over the last few years. Broken bones that healed incorrectly and scars all over her body"

The grey-haired hesitates with another answer and bows his head down, wanting to give Kara and Alex a moment to digest the information. The office is suddenly quieter than it was at the beginning of the conversation. "What about Gracie?"

The man in front of them started to smile and looked at the two older Danvers with glittering eyes. "Despite the circumstances, your sister did a good job. Grace Danvers is a bright little girl with particularly good language skills despite her young age"

"Any signs of injury? Does she have bruises or healed broken bones?

He shook his head violently and took away all their fears with immediate effect. "No, she is a perfectly healthy girl. No vitamin deficiencies or signs of violence. No evidence of past fractures or other medical conditions. If I did not know better, I would say that her mother endured all of the abuse to protect her daughter"

The Danvers sisters nodded in unison and thanked your doctor for treating you so lavishly. Kara put one foot in front of the other as she left the office and waited for Alex to join in step. Together they walked back to your hospital room while going over the details of the injuries you had sustained in their minds.

ᕚ---ᕘ

A week had passed in which you slowly regained your strength in the hospital, slowly got used to your sisters around you and were able to get closer with them. While you were still adjusting to your new, free life, your little daughter explored everything she could get her hands on; running around the hospital with either Kara or Alex always by her side, having her aunts wrapped around her little finger since day one.

You stood nervously with your back to one of your older siblings, staring longingly out the window while your bony hand rested on the pane of glass. A sinister life stretched out behind it; a life you no longer knew. "I do not know if I am ready yet.." you replied to Kara, who sat on your bed and waited for you to take the first step outside. The first step to freedom and into a new life.

"There will never be a perfect moment, sweetheart. Nobody wants to imagine what you went through, but Alex and I will be by your side and support you. No matter how long it takes"

You nodded, saw her soft smile in the reflection and turned to her. The blonde extended her hand. You walked the last few inches that separated you, grabbed her hand so she could pull you into her arms. "Grace is already at the car with Alex and Maggie, trying out the new Nemo seat we bought for her"

You laughed briefly at the thought of how long and in how many stores the redhead must had been, desperate to find a car seat with your daughters favorite fish on it. She had wished for this one and, at the tender age of four, had already threatened not to sit in anything else but this one.

"We can go as soon as you are ready," softly, she kissed your dry and straggly hair, wrapped her arms tightly around you and savored the closeness she had missed so badly. You too snuggled up to her chest like a cat, took a deep breath of her perfume, which she still wore after all these years and let the moment sink in.

Kara´s heartbeat accelerated in your ears and her grip on you became tighter. A slight tremor emanated her body and her swallowing became stronger and heavier.

The sadness that overcame her was like an old friend who had accompanied her on the journey over the past few years. Not intrusive, but always in the foreground; always aiming to get her attention and cause deep pain where your love and closeness once found its place.

It stroked her hair every time she walked into your old room, whispered softly in her ear as in silent moments, she slid down the wall and broke down crying. Never leaving her side and always staying with her. The crushing feeling of never seeing you again, never hearing your footsteps creaking on the floor and never catching the sound of your voice ever again.

Your disappearance painted her world gray, pouring concrete over the once colorful rainbows of your being. You were the biggest concern between all the others. Your sisters were worn down by this eternal struggle - the circle of cause and effect, crime and punishment, guilt and innocence, victim and perpetrator. She had not stopped fighting this fight, but she wished she could.

And now she could finally feel the sun and see the colors again, the warmth she longed for and the soft melody of your voice that returned. "I have missed you so much," she said carefully, rocking you gently in her arms. Kara did not want to let go of you, she had been longingly waiting for this moment for too long.

"After all these years, have you stopped looking for me?"

"Yes, we did," she whispered into your hair, the pain in her voice clearly audible as salty tears strayed onto them. The blonde rested her trembling chin on the top of your head, gently stroking your shoulder while her other hand nervously played with your fingers. It was not until she composed herself that she pulled away from you just inches to look into your eyes. "We all spread out across National City and knocked on every door. We questioned alleged witnesses. But nobody had seen you or knew where you were."

Tears rolled quietly down your face, which Kara caught with the soft pads of her thumbs. Although you had asked the question yourself, your stomach still cramped completely when receiving the given information. Your family had fought through the struggle of your disappearance and given themselves up in the process. They had long since lost hope.

"I am sorry I caused you such pain," you looked at your hands and waved them around as if seeing them for the first time before closing your eyes for a brief moment. Shortly after, you opened them up again and stared at your sister with blank eyes. Kara´s on the other hand were blood red and swam behind thick glasses.

She quickly fell to the ground and knelt in front of you. Her warm hands were placed on your cheeks, her thumbs inevitably caressing them. "You are not to blame for what happened to you and you are not guilty for surviving it. Sure, we suffered pain because we thought we lost you forever, but you know what outweighs that pain?"

You shook your head and cocked it to the side, her hand now clasped between your shoulder and ear. She smiled at you briefly and pulled you to the front so your face was buried in her shoulder. "You are back and our hearts are whole again. You are so strong, a fighter and fought your way through everything that came your way. You do not have to be sorry. It. is. not. your. fault."

[crosstheveil]

Health: Misconceptions with Anemia and "Iron Deficiency"

Iron Absorption & Utilization

Simply taking iron supplements often doesn't cure anemia.

Proper absorption and utilization of iron involve many processes.

1/3 of the population has trouble absorbing and utilizing iron; it's considered the most common nutritional disorder in the world.

Anemia is usually about iron dysregulation, not deficiency.

Iron supplements or injections tend to circulate excessively, potentially causing toxicity.

Iron overload strains the iron recycling system and the liver.

Liver plays a key role in regulating iron uptake.

Iron doesn't regulate itself; it's copper-dependent.

Copper is essential for ceruloplasmin, a protein that mobilizes iron from tissues into the blood. Without copper, iron accumulates in tissue leading to inflammation and tissue damage which can develop into others issues like heart or liver disease and diabetes with increased risk of infection and cancer.

Retinol (Vitamin A) enhances iron absorption and influences genes regulating iron metabolism.

Iron Testing

CBC can detect anemia but it can't necessarily tell you the cause.

Serum ferritin doesn't give a true measure of iron stores.

Approximately 70% of iron is found in hemoglobin, around 20-25% is stored as ferritin and hemosiderin in tissues, about 5% is in myoglobin and enzymes, and roughly 0.1% as serum iron.

For accurate assessment, consider all containers of iron including hemoglobin, serum iron, and ferritin, as well as non-iron markers such as zinc, copper, and vitamins A & D.

The only direct way to measure iron stores is to keep removing blood until anemia sets in, then account for the iron deficit and dietary iron consumed during this time.

Sources (meat, liver, and seafood)

Copper: liver, nuts, molasses, oats, bee pollen, shellfish, pumpkin seeds, dark chocolate, acerola cherry powder, shilajit.

Retinol (Vitamin A): liver, other organ meats, egg yolk, seafood, fish liver oils, dairy products.

Other Insights

Phytates in plants can hinder non-heme iron absorption but vitamin C helps to counteract these inhibitory effects.

Over-supplementing with zinc can cause copper deficiency since copper and zinc need to be in balance.

There are many causes of anemia beyond "iron deficiency", such as vitamin B12 deficiency.

The Nobel Prize in Physiology or Medicine was awarded in 1934 to George Whipple, George Minot, and William Murphy for their discoveries related to liver therapy in cases of anemia.

Other studies have supported incorporating beef liver (which contains copper, iron, zinc, vitamin A and D) into the diet.

The key is to have food that isn't concentrated on a certain vitamin or mineral but provides a mixture of what we need in a way that our body can properly absorb without inhibiting effects.

Men are naturally higher in iron than women and women are naturally higher in copper than men (estrogen levels contribute to the production of copper).

Female menstruation is why iron deficiency anemia is more common among women.

Signs of anemia include fatigue, pale complexion, blurred vision, dizziness, irregular heartbeat, cold hands and feet, scanty menstruation, numbness, insomnia, poor memory, dry skin, brittle nails, vertical ridges on nails, muscle twitches, shortness of breath, chest pain, headache, swollen or sore tongue, unusual cravings, restless legs.

[sourcreammachine]

it’s widely known that extremely pale skin was seen as a beauty symbol in feudal-era europe, as it was interpreted as a sign of nobility (as the noble would never have to labour outside, hence the term ‘blue blood’, from pronounced and visible veins).

however, as evidenced by the dramatic increase in cases in the post-lightbulb era, it is extremely easy while living in europe to become deficient in vitamin D, a condition which often presents with myopathy - general malaise, pain, and impaired physical function - which is known to manifest in agitation, depression, fatigue, and other such psychological and psychosomatic symptoms.

as such, the centuries of callousness, irrationality, pettiness, and cruelty waged by the ruling caste against their own people after the ascension of feudal court culture could be directly explained by endemic vitamin D deficiency. in this essay i will

[feminist-space]

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

by Patrick Rucker, Maya Miller and David Armstrong for ProPublica

March 25, 5 a.m. EDT

Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.

When a stubborn pain in Nick van Terheyden’s bones would not subside, his doctor had a hunch what was wrong.

Without enough vitamin D in the blood, the body will pull that vital nutrient from the bones. Left untreated, a vitamin D deficiency can lead to osteoporosis.

A blood test in the fall of 2021 confirmed the doctor’s diagnosis, and van Terheyden expected his company’s insurance plan, managed by Cigna, to cover the cost of the bloodwork. Instead, Cigna sent van Terheyden a letter explaining that it would not pay for the $350 test because it was not “medically necessary.”

The letter was signed by one of Cigna’s medical directors, a doctor employed by the company to review insurance claims.

Something about the denial letter did not sit well with van Terheyden, a 58-year-old Maryland resident. “This was a clinical decision being second-guessed by someone with no knowledge of me,” said van Terheyden, a physician himself and a specialist who had worked in emergency care in the United Kingdom.

The vague wording made van Terheyden suspect that Dr. Cheryl Dopke, the medical director who signed it, had not taken much care with his case.

Van Terheyden was right to be suspicious. His claim was just one of roughly 60,000 that Dopke denied in a single month last year, according to internal Cigna records reviewed by ProPublica and The Capitol Forum.

The rejection of van Terheyden’s claim was typical for Cigna, one of the country’s largest insurers. The company has built a system that allows its doctors to instantly reject a claim on medical grounds without opening the patient file, leaving people with unexpected bills, according to corporate documents and interviews with former Cigna officials. Over a period of two months last year, Cigna doctors denied over 300,000 requests for payments using this method, spending an average of 1.2 seconds on each case, the documents show. The company has reported it covers or administers health care plans for 18 million people.

Before health insurers reject claims for medical reasons, company doctors must review them, according to insurance laws and regulations in many states. Medical directors are expected to examine patient records, review coverage policies and use their expertise to decide whether to approve or deny claims, regulators said. This process helps avoid unfair denials.

But the Cigna review system that blocked van Terheyden’s claim bypasses those steps. Medical directors do not see any patient records or put their medical judgment to use, said former company employees familiar with the system. Instead, a computer does the work. A Cigna algorithm flags mismatches between diagnoses and what the company considers acceptable tests and procedures for those ailments. Company doctors then sign off on the denials in batches, according to interviews with former employees who spoke on condition of anonymity.

“We literally click and submit,” one former Cigna doctor said. “It takes all of 10 seconds to do 50 at a time.”

Not all claims are processed through this review system. For those that are, it is unclear how many are approved and how many are funneled to doctors for automatic denial.

Insurance experts questioned Cigna’s review system.

Patients expect insurers to treat them fairly and meaningfully review each claim, said Dave Jones, California’s former insurance commissioner. Under California regulations, insurers must consider patient claims using a “thorough, fair and objective investigation.”

“It’s hard to imagine that spending only seconds to review medical records complies with the California law,” said Jones. “At a minimum, I believe it warrants an investigation.”

Within Cigna, some executives questioned whether rendering such speedy denials satisfied the law, according to one former executive who spoke on condition of anonymity because he still works with insurers.

“We thought it might fall into a legal gray zone,” said the former Cigna official, who helped conceive the program. “We sent the idea to legal, and they sent it back saying it was OK.”

Cigna adopted its review system more than a decade ago, but insurance executives say similar systems have existed in various forms throughout the industry.

In a written response, Cigna said the reporting by ProPublica and The Capitol Forum was “biased and incomplete.”

Cigna said its review system was created to “accelerate payment of claims for certain routine screenings,” Cigna wrote. “This allows us to automatically approve claims when they are submitted with correct diagnosis codes.”

When asked if its review process, known as PXDX, lets Cigna doctors reject claims without examining them, the company said that description was “incorrect.” It repeatedly declined to answer further questions or provide additional details. (ProPublica employees’ health insurance is provided by Cigna.)

Former Cigna doctors confirmed that the review system was used to quickly reject claims. An internal corporate spreadsheet, viewed by the news organizations, lists names of Cigna’s medical directors and the number of cases each handled in a column headlined “PxDx.” The former doctors said the figures represent total denials. Cigna did not respond to detailed questions about the numbers.

Cigna's explanation that its review system was designed to approve claims didn’t make sense to one former company executive. “They were paying all these claims before. Then they weren’t,” said Ron Howrigon, who now runs a company that helps private doctors in disputes with insurance companies. “You’re talking about a system built to deny claims.”

Cigna emphasized that its system does not prevent a patient from receiving care — it only decides when the insurer won’t pay. “Reviews occur after the service has been provided to the patient and does not result in any denials of care,” the statement said.

"Our company is committed to improving health outcomes, driving value for our clients and customers, and supporting our team of highly-skilled Medical Directors,” the company said.

PXDX

Cigna’s review system was developed more than a decade ago by a former pediatrician.

After leaving his practice, Dr. Alan Muney spent the next several decades advising insurers and private equity firms on how to wring savings out of health plans.

In 2010, Muney was managing health insurance for companies owned by Blackstone, the private equity firm, when Cigna tapped him to help spot savings in its operation, he said.

Insurers have wide authority to reject claims for care, but processing those denials can cost a few hundred dollars each, former executives said. Typically, claims are entered into the insurance system, screened by a nurse and reviewed by a medical director.

For lower-dollar claims, it was cheaper for Cigna to simply pay the bill, Muney said.

“They don’t want to spend money to review a whole bunch of stuff that costs more to review than it does to just pay for it,” Muney said.

Muney and his team had solved the problem once before. At UnitedHealthcare, where Muney was an executive, he said his group built a similar system to let its doctors quickly deny claims in bulk.

In response to questions, UnitedHealthcare said it uses technology that allows it to make “fast, efficient and streamlined coverage decisions based on members benefit plans and clinical criteria in compliance with state and federal laws.” The company did not directly address whether it uses a system similar to Cigna.

At Cigna, Muney and his team created a list of tests and procedures approved for use with certain illnesses. The system would automatically turn down payment for a treatment that didn’t match one of the conditions on the list. Denials were then sent to medical directors, who would reject these claims with no review of the patient file.

Cigna eventually designated the list “PXDX” — corporate shorthand for procedure-to-diagnosis. The list saved money in two ways. It allowed Cigna to begin turning down claims that it had once paid. And it made it cheaper to turn down claims, because the company’s doctors never had to open a file or conduct any in-depth review. They simply denied the claims in bulk with an electronic signature.

“The PXDX stuff is not reviewed by a doc or nurse or anything like that,” Muney said.

The review system was designed to prevent claims for care that Cigna considered unneeded or even harmful to the patient, Muney said. The policy simply allowed Cigna to cheaply identify claims that it had a right to deny.

Muney said that it would be an “administrative hassle” to require company doctors to manually review each claim rejection. And it would mean hiring many more medical directors.

“That adds administrative expense to medicine,” he said. “It’s not efficient.”

But two former Cigna doctors, who did not want to be identified by name for fear of breaking confidentiality agreements with Cigna, said the system was unfair to patients. They said the claims automatically routed for denial lacked such basic information as race and gender.

“It was very frustrating,” one doctor said.

Some state regulators questioned Cigna’s PXDX system.

In Maryland, where van Terheyden lives, state insurance officials said the PXDX system as described by a reporter raises “some red flags.”

The state’s law regulating group health plans purchased by employers requires that insurance company doctors be objective and flexible when they sit down to evaluate each case.

If Cigna medical directors are “truly rubber-stamping the output of the matching software without any additional review, it would be difficult for the medical director to comply with these requirements,” the Maryland Insurance Administration wrote in response to questions.

Medicare and Medicaid have a system that automatically prevents improper payment of claims that are wrongly coded. It does not reject payment on medical grounds.

Within the world of private insurance, Muney is certain that the PXDX formula has boosted the corporate bottom line. “It has undoubtedly saved billions of dollars,” he said.

Insurers benefit from the savings, but everyone stands to gain when health care costs are lowered and unneeded care is denied, he said.

Speedy Reviews

Cigna carefully tracks how many patient claims its medical directors handle each month. Twelve times a year, medical directors receive a scorecard in the form of a spreadsheet that shows just how fast they have cleared PXDX cases.

Dopke, the doctor who turned down van Terheyden, rejected 121,000 claims in the first two months of 2022, according to the scorecard.

Dr. Richard Capek, another Cigna medical director, handled more than 80,000 instant denials in the same time span, the spreadsheet showed.

Dr. Paul Rossi has been a medical director at Cigna for over 30 years. Early last year, the physician denied more than 63,000 PXDX claims in two months.

Rossi, Dopke and Capek did not respond to attempts to contact them.

Howrigon, the former Cigna executive, said that although he was not involved in developing PXDX, he can understand the economics behind it.

“Put yourself in the shoes of the insurer,” Howrigon said. “Why not just deny them all and see which ones come back on appeal? From a cost perspective, it makes sense.”

Cigna knows that many patients will pay such bills rather than deal with the hassle of appealing a rejection, according to Howrigon and other former employees of the company. The PXDX list is focused on tests and treatments that typically cost a few hundred dollars each, said former Cigna employees.

“Insurers are very good at knowing when they can deny a claim and patients will grumble but still write a check,” Howrigon said.

Muney and other former Cigna executives emphasized that the PXDX system does leave room for the patient and their doctor to appeal a medical director’s decision to deny a claim.

But Cigna does not expect many appeals. In one corporate document, Cigna estimated that only 5% of people would appeal a denial resulting from a PXDX review.

“A Negative Customer Experience”

In 2014, Cigna considered adding a new procedure to the PXDX list to be flagged for automatic denials.

Autonomic nervous system testing can help tell if an ailing patient is suffering from nerve damage caused by diabetes or a variety of autoimmune diseases. It’s not a very involved procedure — taking about an hour — and it costs a few hundred dollars per test.

The test is versatile and noninvasive, requiring no needles. The patient goes through a handful of checks of heart rate, sweat response, equilibrium and other basic body functions.

At the time, Cigna was paying for every claim for the nerve test without bothering to look at the patient file, according to a corporate presentation. Cigna officials were weighing the cost and benefits of adding the procedure to the list. “What is happening now?” the presentation asked. “Pay for all conditions without review.”

By adding the nerve test to the PXDX list, Cigna officials estimated, the insurer would turn down more than 17,800 claims a year that it had once covered. It would pay for the test for certain conditions, but deny payment for others.

These denials would “create a negative customer experience” and a “potential for increased out of pocket costs," the company presentation acknowledged.

But they would save roughly $2.4 million a year in medical costs, the presentation said.

Cigna added the test to the list.

“It’s Not Good Medicine”

By the time van Terheyden received his first denial notice from Cigna early last year, he had some answers about his diagnosis. The blood test that Cigna had deemed “not medically necessary” had confirmed a vitamin D deficiency. His doctor had been right, and recommended supplements to boost van Terheyden’s vitamin level.

Still, van Terheyden kept pushing his appeal with Cigna in a process that grew more baffling. First, a different Cigna doctor reviewed the case and stood by the original denial. The blood test was unnecessary, Cigna insisted, because van Terheyden had never before been found to lack sufficient vitamin D.

“Records did not show you had a previously documented Vitamin D deficiency,” stated a denial letter issued by Cigna in April. How was van Terheyden supposed to document a vitamin D deficiency without a test? The letter was signed by a Cigna medical director named Barry Brenner.

Brenner did not respond to requests for comment.

Then, as allowed by his plan, van Terheyden took Cigna’s rejection to an external review by an independent reviewer.

In late June — seven months after the blood test — an outside doctor not working for Cigna reviewed van Terheyden’s medical record and determined the test was justified.

The blood test in question “confirms the diagnosis of Vit-D deficiency,” read the report from MCMC, a company that provides independent medical reviews. Cigna eventually paid van Terheyden’s bill. “This patient is at risk of bone fracture without proper supplementations,” MCMC’s reviewer wrote. “Testing was medically necessary and appropriate.”

Van Terheyden had known nothing about the vagaries of the PXDX denial system before he received the $350 bill. But he did sense that very few patients pushed as hard as he had done in his appeals.

As a physician, van Terheyden said, he’s dumbfounded by the company’s policies.

“It’s not good medicine. It’s not caring for patients. You end up asking yourself: Why would they do this if their ultimate goal is to care for the patient?” he said.

“Intellectually, I can understand it. As a physician, I can’t. To me, it feels wrong.”

[aita-blorbos]

AITA for trying to kill the guy who ruined my life in a vat of radioactive waste?

So I (17M) had been homeschooled my whole life. My parents have done a pretty good job of teaching me, but I haven’t been able to really talk to or interact with other people my age for years. When I was 16, my doctor suggested I sign up for this summer camp TV competition thing so I could connect with other teens and also do something about my vitamin D deficiency. I was pretty excited to go on! I wasn’t on the actual show for too long since I got kicked off episode one, but it was still neat to hang out with other people besides my parents.

Anyways, that show is where I met C (~47M), the guy that ruined my life. After I got called back on to participate in the third season, I was determined to win this time. It didn’t go to well, I got kicked off first AGAIN, and ended up being a stowaway for the rest of the season. You gotta understand what the conditions were like down there. Barely any food, no sunlight, and the closest thing to a human I could talk to were the rats. I looked like a feral animal, and kind of acted like one too (again, no human contact).

After C found me hiding, I was expecting to get kicked off for good. Instead, he decided to use me in one of the challenges so the other campers could hunt me for sport. And it just got worse after that. Since then, C has thrown me in a volcano, trapped me in a mine shaft filled with radioactive waste, and just generally psychologically tormented me. Through all of this, I haven’t been able to get into contact with my parents and for all they know, I could be dead. So I figured it was only fair for me to try and ruin his life to. So, I kidnapped him and had him dangle over a vat of radioactive waste. Unfortunately it didn’t work, he got saved and I was once again trapped in the mineshaft.

I was just wondering if I was the one in the wrong here. I thought C deserved to die, but quite a few people came to save him. AITA?