Dear Dr. Roach: In a recent test, my blood vitamin D level was good, at 43, but my calcitriol level was low at 16. I do have hyperglycemia, but how do I increase my calcitriol level? I take no medications.
Dear J.L.: If you don’t have kidney or parathyroid hormone problems, then calcitriol isn’t the right blood test to determine your bone health relative to vitamin D.
Calcitriol is an activated form of vitamin D, and it best reflects calcium intake. I suspect low calcium intake when I see a high calcitriol. Since calcitriol removes calcium from the bones, it may worsen osteoporosis.
If you haven’t had your kidneys and parathyroid hormone level (which also affects calcium movement in the kidney and bones) checked recently, then do so.
If those are OK, then be sure to get enough calcium, especially from dietary sources like leafy green vegetables.
Dear Dr. Roach: I have diverticulosis. At one time I was told not to eat nuts. I have since read that eating nuts is OK. What is your take? Also, are chia seeds safe?
Dear E.M.: There are two answers to this question. The first comes from clinical research, and a very large trial showed that nut and popcorn consumption tended to protect against diverticulitis and diverticular bleeding. This may be due to the high fiber content, recommended in people with diverticula. So most experts allow their patients with diverticulosis to eat nuts and seeds, including chia seeds.
The second is practical experience. If someone has had clinical diverticulitis after eating nuts and seeds, especially if it happens repeatedly, it makes sense not to do so.
Email questions to ToYourGoodHealth@med.cornell.edu.