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Peter asked...

I was diagnosed with SLL

I was diagnosed with SLL in November 2010 and attend the oncology o/p clinic at Southampton General at 6 monthly intervals. I remain well & apart from a flare up in Dec. 2010, my lymph nodes have not enlarged further. Because of my concern about immune deficiency my GP arranged a Vit. D3 blood test. The result was 54 nmo/L (2nMo/L above the min. recommended. I was prescribed Adcal-D3 which contains calcium carbonate and vitamin D3 for bone conditions. From my research I gather that D3 at a daily dose of 2600IU is necessary. The D3 content of Adcal-D3 is only 400IU and I appear not to need the Cal. Carbonate. Please could you advise Kind regards

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The answer

Small Lymphocytic Lymphoma (SLL) is a condition which causes a rise in white blood cell production, enlarging lymph nodes and a resulting malfunctioning immune system. Although vitamin D deficiency is not the cause for this condition low levels of this vitamin may further impair normal function of the immune system. Vitamin D is also important for bone function and general health and symptoms of more severe deficiency include fatigue, muscle and joint pain, weight gain and increased blood pressure.  For those with blood levels of vitamin D above 45 the necessary daily amount of vitamin D needed is 2,000-4,000 i.u. depending on the persons age, skin colour and the amount of sunlight they are exposed to each day.  The body actually makes some of this vitamin D through skin sunlight exposure so you don't need all of this amount in dietary form but if you don't get any sun exposure you will obviously need nearer to the higher range in the form of dietary intake.  As an average figure those with normal vitamin D levels ( >45) and of less than 70 years of age are recommended to get at least 600 i.u. of dietary vitamin D per day.  Oily fish, beef, full fat milk, cheese and egg yolk contain vitamin D but if additional supplementation is needed then twice daily adcal D 3 would provide enough to cover this. If you are already getting adequate calcium through dietary sources then you can get tablets of vitamin D without calcium either at health food stores, chemists or on prescription.

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