Author Archives: sararodgers

Micro Needling and Nano Needling

For more beautiful skin

What is Micro Needling?

Micro Needling, also known as Collagen Induction Therapy, is a minimally invasive procedure that allows for controlled induction of growth factor serums, or hyaluronic acid, into the skins self-repair process by creating micro injuries in the skin. These injuries stimulate new collagen production, while not posing the risk of permanent scaring.

Results may include improved skin tone, skin texture; firmness; and reduction in scars, sunspots, pore size, and possibly stretch marks.

During Micro Needling the top layer of the skin remains intact, unlike skin peels.

What is Nano Needling?

Nano Needling can be received once weekly to supplement the Micro Needling treatment, support absorption of beneficial serums, and to support exfoliation.

Nano needling is used in areas of thinner skin, such as the area around the eyes.  

Beneficial Facial Serums

Micro Needling may increase the skin’s ability to utilize the nutrients by up to 3,000 %.

During the Micro Needling and Nano Needling treatment, one or more serums may be applied to the skin. These serums are formulated to nourish and hydrate the skin.

Some of the serums used include:

  • Hyaluronic Acid is found naturally in the skin. It forms a gel like substance when combined with water and is helpful to fill out wrinkles. It is also involved in wound healing. Hyaluronic acid may be applied to your skin and it the base for many of the beneficial serums used.
  • Apple Stem Cells. This serum is used to rejuvenate the skin cells to act more like they did in youth.  The result may include reduced  wrinkle/line formation, more tight skin, and more glowing skin.
  • Other serums using herbal formulas are designed to reduce age and sunspots.

The needling procedure helps to drive the serums into the skin.  After treatment your skin is more open to absorb 24 hours after treatment. You will be sent home with serums to enhance your treatment.

FAQ

What conditions may be improved?

Micro and Nano Needling may help improve:

  • Skin tone
  • Skin texture
  • Skin Firmness
  • Wrinkles
  • Sunspots
  • Scar tissue
  • Pore size
  • Hair growth

How do I prepare prior to my Micro Needling session? 

  • Do not wear makeup to the session or be prepared to remove your make up prior to your session.
  • Allow 24 hours after your session to avoid direct sunlight, wind, dust.
  • Be prepared that your face may look red and/or dry after your session.

Are the needles re-used?

Each treatment uses new, sterile needles. After treatment, these needles are then properly disposed.

Does it hurt?

Micron Needling may be painful or induce a tickling sensation, depending on how deep the needles are inserted.

Pain usually resolves after the treatment, but redness may take 24 hours to resolve.

How deep do the needles go?

The Micro Needling pen can be set to penetrate skin from 0.5-2.5 mm deep.

Nano Needles penetrate the top 0.15 mm layer of skin.

How long is a treatment

Treatments usually last 30 minutes.

What results can I expect from the treatment?

Initially, the skin may remain red and dry for approximately 24 hours after a treatment.

The skin heals by producing more fibroblasts and collagen. This process helps “plump up” the skin and fill in wrinkles. As the skin heals itself and produces more collagen and fibroblasts to create smoother, firmer, and younger looking skin.

It may take 2-4 months of treatment to see the effects desired.

Are there side effects?

  • Skin will be pink or red and may feel warm, like mild sunburn, tight and itchy, which usually subside in 12 to 24 hours
  • Minor flaking or dryness of the skin, with scab formation in rare cases. 
  • Crusting, discomfort, bruising and swelling may occur.
  • Pinpoint bleeding.
  • It is possible to have a cold sore flare if you have a history of outbreaks.
  • Freckles may lighten temporarily or permanently disappear in treated areas.
  • Infection is rare but if you see any signs of tender redness or puss notify our office immediately.
  • Hyperpigmentation (darkening of the skin) rarely occurs and usually resolves itself after a month.
  • Permanent scarring (less than 1%) is extremely rare.

How often can I receive Micro Needling? 

Micro Needling is recommended no more than once monthly to allow skin to repair and improve.

How often can I receive Nano Needling? 

Nano Needling can be obtained weekly to supplement the benefits of Micro Needling.

Who should NOT get Micro or Nano Needling.

The following conditions may be a contra indication for Micro Needling or Nano Needling.  Please discuss your condition with the physician before signing up for this procedure.

  • Keloid or raised scarring
  • Bleeding disorders
  • Use of blood thinners/anti coagulants (ie, Coumadin, Warfarin)
  • Elevated blood pressure
  • Immune disorders that prevent adequate tissue healing
  • Eczema
  • Psoriasis
  • Actinic keratosis
  • Non active herpes simplex

Absolute Contraindications. Individuals with the following conditions or treatment should not be treated with Micro or Nano needling.

  • Accutane within last 6 months of desired treatment
  • Scleroderma
  • Collagen vascular disease
  • Cardiac abnormalities
  • Rosacea
  • Uncontrolled blood clotting problem
  • Platelet abnormalities
  • Facial cancer, past and present
  • Chemotherapy
  • Steroid therapy
  • Dermatological diseases affecting the face (i.e. Porphyria)
  • Uncontrolled Diabetes and other chronic conditions
  • Active bacterial or fungal infections
  • Immune suppression conditions or treatment
  • Scars less then 6 months old
  • Botox/facial fillers in the past 2-4 weeks.
  • Silicone antibody disease, silicone allergy or silicone sensitivity
  • Pregnancy, Nursing

Research

  • Wall D, Meah N, Fagan N, York K, Sinclair R. Advances in hair growth. Fac Rev. 2022 Jan 12;11:1. doi: 10.12703/r/11-1. PMID: 35156098; PMCID: PMC8808739.C
  • Chilicka K, Rusztowicz M, Szygu?a R, Nowicka D. Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review. J Clin Med. 2022;11(10):2744. Published 2022 May 12. doi:10.3390/jcm11102744
  • El-Domyati M, Barakat M, Awad S, Medhat W, El-Fakahany H, Farag H. Microneedling Therapy for Atrophic Acne Scars: An Objective Evaluation. J Clin Aesthet Dermatol. 2015 Jul;8(7):36-42. PMID: 26203319; PMCID: PMC4509584.
  • Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D (2009) Acne scarring treatment using skin needling. Clin Exp Dermatol 34: 874-879.
  • Fabbrocini G, Annunziata MC, D’Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G (2010) Acne scars: Pathogenesis, classification, and treatment. Dermatol Res Pract 2010: 893080.
  • Fife D (2011) Practical evaluation and management of atrophic acne scars. Tips for the general dermatologist. J Clin Aesthet Dermatol 4: 550-57.
  • Goodman G (2003) Post acne scarring: a review. J Cosmet Laser Ther 5: 77-95.
  • Goodman GJ, Baron JA (2006) Post acne scarring: a qualitative global scarring grading system. Dermatol Surg 32: 1458-1466.
  • Jacob CI, Dover JS, Kaminer MS (2001) Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 45: 109-117.
  • Leheta TM, Abdel Hay RM, Hegazy RA, El Garem YF (2012) Do combined alternating sessions of 1540 nm nonablative fractional laser and percutaneous collagen induction with trichloroacetic acid 20% show better results than each individual modality in the treatment of atrophic acne scars? A randomized controlled trial. J Dermatolog Treat epub ahead of print.
  • Leheta TM, Abdel Hay RM, El Garem YF (2012) Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid20 in atrophic post-acne scars: a randomized controlled trial. J Dermatology Treat epub ahead of print.
  • Leheta T, El Tawdy A, Abdel Hay R, Farid S (2011) Percutaneous collagen induction versus full-concentration trichloroacetic acid in thetreatmentofatrophicacnescars. DermatolSurg37:207-216.
  • Levy LL, Zeichner JA (2012) Management of acne scarring, Part II: A comparative review of non-laser based, minimally invasive approaches. Am J Clin Dermatol 13:331-340.
  • Shah SK, Alexis AF (2010) Acne in skin of color: practical approaches to treatment. J Dermatolog Treat 21:206-2

Cancer Screening

Cancer is a significant cause of death in the US. According to the CDC, 1.7 million cancers were detected in 2019. For every 100,000 people, 439 cancers were detected, and 146 people died of cancer.

There are cancer screening exams and blood tests for skin, breast, cervical, ovarian, colon, and prostate cancers. For those susceptible, lung and liver screening exams are also available. These test have proven great worth in detecting cancer, hopefully in early and treatable stages. Unfortunately, there are not screening exams for every type of cancer. Sadly, 71% of cancer deaths are from cancers not commonly screened for.

New technologies are also helping to detect more cancers. The Galleri test is a multi-cancer detection blood test that uses DNA analysis to screen for over 50 types of cancer. Although no screening test is 100% accurate, Galleri is expanding the possibilities for detecting more cancers, and in earlier stages.

How it works: healthy vs cancer DNA detection by Galleri

Watch a video HERE (see bottom of that webpage) to learn how this test works.

The stats according to Galleri:

  • Finding it early to treat early. When detected early, cancer 5-year mortality rates are low at 11% as compared to late detection 5-year mortality rates of 79%.
  • Specificity is 99.5%. This means that the false positive rate: is 0.5%. If the test returns as negative, more than likely, there is no cancer.
  • 76.3% sensitivity ( a true positive) for the 12 cancers responsible for 2/3 of all cancer deaths. These cancers include anal, bladder, colon/rectum, esophagus, head/neck, liver/bile duct, lung, lymphoma, ovary, pancreas, plasma cell neoplasm, and stomach.
  • For all 50 cancers screened, there is a 43.1% positive predictive value of cancer present. The positive predictive value drops from 76.3% to 43.1% due to the difficulty in obtaining DNA from some tumors, including prostate and thyroid.
  • 89% of tests were able to detect the correct originating organ producing the cancer.

Galleri is not a substitute for regular cancer screening, but can add quality information to influence your health decisions. Galleri is not FDA approved and may not be covered by your insurance. If cancer is suggested by this test, confirmatory testing is suggested.

Dr. Rodgers is offering this test to patients 50 years and older.

List of research:

Klein EA, Richards D, Cohn A, et al. Clinical validation of a targeted methylation-based multi-cancer early detection test using an independent validation set. Ann Oncol. 2021;32(9):1167-1177. doi:10.1016/j.annonc.2021.05.806

Nadauld LD, McDonnell CH 3rd, Beer TM, et al. The PATHFINDER Study: Assessment of the Implementation of an Investigational Multi-Cancer Early Detection Test into Clinical Practice. Cancers (Basel). 2021;13(14):3501. Published 2021 Jul 13. doi:10.3390/cancers13143501

What is Detox?

As a naturopathic student and resident, Dr. Rodgers was privileged to learn from one of the best detox physicians in the country: Dr. Walter Crinnion, ND.  Dr. Crinnion taught that there are 5 Steps to detoxification: 

  1. Avoid
  2. Avoid
  3. Avoid
  4. Supplementation
  5. Depuration

Avoid refers to avoiding getting exposed to and filled up with toxins from air, water, food, or personal care products. This also includes avoiding the light, noise, and electromagnetic frequency (EMFs) disturbances that emanate from devices such as smart phones, pads, TV’s, etc.

Supplementation refers to targeted nutrients and herbs that support metabolic detoxification pathways.

Depuration is the process of removing toxins from the body.

In reality, we cannot avoid all toxins. Fragrance, forest fire smoke, wireless technology, and volatile organic substances (VOC’s) in our homes, offices, automobiles, clothes, cleaning products, etc., are unavoidable all the time, but there are some habits that can reduce exposure.   

  1. Be aware and be proactive. Start by creating non toxic home, work, and hopefully school spaces.  See HERE for some simple ideas; be sure to follow the links in the original article.
  2. Vitamin C.  Vitamin C is an amazing compound, one unfortunately we humans do not synthesize in our bodies. (Dogs, cats, goats all make vitamin C, but we humans, Guinea pigs, some monkeys, and some bats lack the enzyme to manufacture Vitamin C). Vitamin C is water soluble, so we need to take this daily. 
  3. Make sure you are able to detox .  Do activities that cause you to perspire regularly. Make sure you are having a bowel movement (yes, its pooping) at least once daily. If you are not able to perspire or poop regularly, please consult with your health provider to help fix these issues.
  4. Exercise. Exercise helps move blood throughout the body and increases metabolism. 
  5. Learn how to reduce Electromagnetic Frequency pollution we get from our smart devices, wi-fi, and potentially our electric vehicles. Click HERE to download a free guide developed by Cathy Cooke, building biologist, of Whole Home and Body Health on the  Top 10 Ways to Reduce Your EMF exposure. Take this seriously.
  6. Consider a regular cleanse.  We are all exposed to environmental toxins daily. Some people are more susceptible to toxins, but it is hard to determine how much daily exposure affects any of us as we age and become more susceptible to chronic disease. Active cleansing 1-4 times yearly helps invigorate our detox enzymes, support our gastrointestinal bacteria, and reduces our toxic burden.

Dr. Rodgers is a detoxification specialist and can guide you in reducing your toxic body burden.  Besides providing targeted nutritional supplementation to support detoxification, Dr. Rodgers utilizes laboratory analysis that help to identify toxic burdens of inflammatory gut pathogens, pesticides and/or toxic metals.

Menstruation Lecture

I was recently asked to participate in a Women’s Health Lecture Series at 4 Rivers Cultural Center in Ontario, Oregon. Here is my portion of the first lecture. You can find the full mensuration lectures HERE. As my lecture was hard to hear, I’m re-posting the power point lecture. HERE

Can an herbicide cause Aging?

One of the most popular weed-killing products used today is glyphosate, commercially sold as Round-Up. There is a lot of controversy about this chemical, including potential cancer risks. However, did you know that glyphosate may also promote aging? A recent study looked at how glyphosate and its metabolite aminomethylphosphonic acid (AMPA) affects DNA and gene expression, also referred to as epigenetic changes. Glyphosate’s metabolite AMPA “was associated with greater epigenetic age acceleration.” Both Glyphosate and AMPA were found to be “associated with DNA methylation differences that could promote the development of cancer and other diseases.” https://doi.org/10.1289/EHP10174
Manually pulling weeds may take more time, but the benefits include getting some exercise and stress reduction found from interacting with the earth. However, if spraying weeds is more your style, then consider using a 20% vinegar solution. Vinegar dehydrates the weeds without dehydrating your DNA!

Are you ready for the Pollen Invasion?

A lilac bloom plotting for the next Sneeze.

As the last vestiges of winter depart,
Leaving us looking forward to warmer weather and longer days,
We must also look to the health of our sinus and bronchial passages.
Spring flowers embrace us with beauty and fragrance, but
We may also become coated with POLLEN.

A-CHOO!

Here are some suggestions to remain snot, cough, and fatigue-free during the allergy season.

  1. Masks.  Face Masks can reduce your inhalation of pollen. Consider a mask when pollen counts are high, when walking in windy weather, cleaning up the garden, or during fire smoke season.  For chemically sensitive individuals, a N95 or equivalent standard mask can reduce unexpected exposure to fragrance.  
    1. Here is an on-line resource to learn what type of pollen is the air: https://pollencount.app/
    1. You may also want to download any weather app that has pollen count info.
  2. Keep windows closed at night. We spend 6-8 hours nightly in a relaxed breathing state.  This is a great time for pollen to enter our breathing passages and create havoc! Keep your windows closed to help reduce pollen inhalation.
  3. Air Purification.  An air purifier can reduce pollens that sneak in when your door or windows are open. 
  4. Use a damp rag to reduce pollen on your indoor/outdoor pet’s coat.  Animals that spend time outside may bring in pollen on their coat. A damp rag over your pet’s coat may reduce invasion of pollen into your home.
  5. Supplementation. Vitamin C and bioflavonoids such as quercetin may help stabilize mast cells that produce the histamine that will make your nose miserably drippy.
  6. Herbs.  Nettle leaf as tea or tincture may help also stabilize your mast cells.  Caution, nettles may also act as a diuretic (increase urine flow). Do not use Nettles if you currently take any cardiovascular medications without first consulting your medical provider.
  7. Know your food sensitivities? If you know you react to certain foods, now is the time to avoid these foods diligently. If you don’t know if certain foods increase inflammation, now is the time to find out. Dr. Rodgers offers methods to help you identify your food sensitivities.

Staying healthy with A healthy Lymphatic System.

Glenda Bell, LMT of Radical Lymphatic Therapy describes why taking care of our Lymphatic System is so important.

Lymphatic Massage helps clear toxins from the body and support the Immune System. it is an excellent technique to move toxins from breast tissue, decrease inflammation before and after surgery, and perhaps even re-set emotional trauma.

Low Dose Naltrexone: a Pain Management Alternative to Opioids

I recently interviewed Dr. Madison Peach-Keen of Medicap Pharmacy to learn more about a Low Dose Naltrexone (LDN) as a safer pain management alternative to opioid drugs. When people are prescribed opioids following surgery or an accident, they may find themselves unwillingly addicted to these powerful medications. Opioids prescriptions have led to a national epidemic of overdose deaths. Low Dose Naltrexone may be a safe alternative to help reduce the dose or wean off opioids. Watch the interview HERE.

https://youtu.be/1D9lxPsGUro

Why is Vitamin D so important in combating COVID-19?

The answer lies in Vitamin D’s hormone effects. Vitamin D is labeled a vitamin, but most of its properties reside in its hormonal affect. I affectionally call Vitamin D a “Vitamone” because it acts as both a vitamin and a hormone.

As a hormone, Vitamin D is most known for helping to build strong bones.  It is less recognized for its immune signaling affects.  When activated, the Vitamin D receptor signals the immune system and induces anti-viral responses including reducing viral replication, reducing viral penetration of cells, and signaling the immune system to kill infected cells.[1]  

Regarding the current COVID pandemic, Vitamin D may be a crucial nutrient to reduce hospitalization and mortality. When Vitamin D levels are low, COVID-19 has a better chance to trigger an inflammatory cascade, causing significant illness. Studies are now finding that COVID patients with low Vitamin D levels have higher risk of needing intense hospital care,[2] and Vitamin D supplementation may reduce mortality in COVID-19 patients admitted to hospital.[3] ,[4], [5] 

COVID-19 poses further risk for a subset of the infected population that may clear the virus but continue to have symptoms. Post-COVID syndrome, also known Long-COVID, may present with symptoms such as fatigue, headache, lower attention, hair loss, shortness of breath, loss of taste/smell, chest pain, cough, sleep disruption, and joint pain[6] lasting more than 3 weeks following an initial infection.  Long-COVID syndrome may occur in for both vaccinated and non-vaccinated infected individuals.

Some researchers theorize that Long-COVID may be due to the re-emergence of past viral infections, such as Kaposi’s sarcoma-associated herpesvirus (KSHV) and Epstein-Barr virus. [7], [8] With its important role in combating other viruses (Epstein-Barr, Influenza (H1N1), Hepatitis C, Rota, and Dengue), [9], [10], [11], [12] Vitamin D may be an important component in preventing or treating Long-COVID.

Thus, maintaining healthy levels of Vitamin D may reduce the severity of a COVID-19 infection while also reducing the chance of triggering the onset Post-COVID syndrome.

So, what to do:

  1. Testing for Vitamin D levels is important.

In my experience, supplementation and sun exposure do not always correlate with actual Vitamin D levels.  Laboratory blood testing is really the only way to know your Vitamin D levels.

I suggest the following Vitamin D testing schedule.

  • Test both 25(OH) Vitamin D and 1,25(OH)2D3
  • Test in the late Summer/Early Fall to determine how well activities in the summer support your Vitamin D levels.
  • Test in Winter to ensure healthy levels during the period of lowest sunlight exposure and highest viral infection risk.

Always make a note next to your test results about level of sun exposure and the Vitamin D dose/product you had for the previous month. This will help you determine and remember what works and doesn’t work to maintain healthy Vitamin D levels.

  • Supplementation

I usually suggest 1,000-5,000 IU (25-250 mcg) daily, based on individual patient needs. If you are not currently a patient of Dr. Rodgers, please ask your medical provider about your Vitamin D dosage needs.

Dose is based on your blood work results:

  • Vitamin D insufficiency is defined as blood levels <30 ng/dL. However, this level may be insufficient to protect one against the inflammatory storm. Conventional physicians may suggest blood levels between 30-50 ng/dL.  As a naturopath, I was taught to achieve blood levels between 60-80 ng/dL. 
  • As a vitamin, Vitamin D helps to make Dopamine, which breaks down into epinephrine and norepinephrine (types of adrenalin). For some people who can’t breakdown adrenalin appropriately, too much Vitamin D may result in anxiety. For those patients whose anxiety worsens with Vitamin D supplementation, I suggest maintaining blood levels ~30 ng/dL.
  • It is important to remember that ingesting too much Vitamin D may cause calcium levels to rise too much (hypercalcemia) and deposit in tissues, including the kidney (i.e., kidney stones).  Some studies have found this risk to be low,[13] but other studies suggest trends of hypercalcemia occurs at doses ? 2,800 IU/day, but without any adverse events.[14] 

If you test low, please supplement safely and re-test 6 weeks after starting supplementation to ensure you have achieved healthy levels.

Types of Vitamin D supplements

Cholecalciferol (Vitamin D3) is the preferred form of Vitamin D, but if one has liver failure or severe intestinal malabsorption syndrome, Calcifediol (25-hydroxyvitamin D3) may be more appropriate.[15]  Calcifediol is a prescription medication and not available as nutritional supplement.

Conclusions

  1. Maintaining healthy Vitamin D levels may significantly reduce COVID-19 induced inflammatory storms.
  2. Vitamin D may reduce the re-emergence of other viruses, including those responsible for Epstein-Barr syndrome or cancers.
  3. Testing one’s Vitamin D blood levels is the best way to determine if Vitamin D supplementation is optimal or needs adjusting.

[1] Xu Y, Baylink DJ, Chen CS, et al. The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19. J Transl Med. 2020;18(1):322. Published 2020 Aug 26. doi:10.1186/s12967-020-02488-5

[2] Diaz-Curiel M, Cabello A, Arboiro-Pinel R, et al. The relationship between 25(OH) vitamin D levels and COVID-19 onset and disease course in Spanish patients. J Steroid Biochem Mol Biol. 2021;212:105928. doi:10.1016/j.jsbmb.2021.105928

[3] Nogues X, Ovejero D, Pineda-Moncusí M, et al. Calcifediol Treatment and COVID-19-Related Outcomes. J Clin Endocrinol Metab. 2021;106(10):e4017-e4027. doi:10.1210/clinem/dgab405

[4] Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al. “Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study”. J Steroid Biochem Mol Biol. 2020;203:105751. doi:10.1016/j.jsbmb.2020.105751

[5] Nogues X, Ovejero D, Pineda-Moncusí M, et al. Calcifediol Treatment and COVID-19-Related Outcomes. J Clin Endocrinol Metab. 2021;106(10):e4017-e4027. doi:10.1210/clinem/dgab405

[6] Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144. Published 2021 Aug 9. doi:10.1038/s41598-021-95565-8

[7] Chen J, Dai L, Barrett L, et al. SARS-CoV-2 proteins and anti-COVID-19 drugs induce lytic reactivation of an oncogenic virus. Commun Biol. 2021;4(1):682. Published 2021 Jun 3. doi:10.1038/s42003-021-02220-z

[8] Lehner GF, Klein SJ, Zoller H, Peer A, Bellmann R, Joannidis M. Correlation of interleukin-6 with Epstein-Barr virus levels in COVID-19. Crit Care. 2020;24(1):657. Published 2020 Nov 23. doi:10.1186/s13054-020-03384-6

[9] Brütting C, Stangl GI, Staege MS. Vitamin D, Epstein-Barr virus, and endogenous retroviruses in multiple sclerosis – facts and hypotheses. J Integr Neurosci. 2021;20(1):233-238. doi:10.31083/j.jin.2021.01.392

[10] Villar LM, Del Campo JA, Ranchal I, Lampe E, Romero-Gomez M. Association between vitamin D and hepatitis C virus infection: a meta-analysis. World J Gastroenterol. 2013;19(35):5917-5924. doi:10.3748/wjg.v19.i35.5917

[11] Dissanayake S, Tennekoon S, Gaffoor S, Liyanage G. Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study. J Trop Med. 2021;2021:4173303. Published 2021 Oct 14. doi:10.1155/2021/4173303

[12] Suares A, Tapia C, González-Pardo V. VDR agonists down regulate PI3K/Akt/mTOR axis and trigger autophagy in Kaposi’s sarcoma cells. Heliyon. 2019;5(8):e02367. Published 2019 Aug 27. doi:10.1016/j.heliyon.2019.e02367

[13] Ganji MR, Shafii Z, Hakemi MS. Vitamin D Supplementation and Risk of Hypercalciuria in Stone Formers. Iran J Kidney Dis. 2019;13(1):27-31.

[14] Malihi Z, Lawes CMM, Wu Z, et al. Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: results from a randomized controlled trial. Am J Clin Nutr. 2019;109(6):1578-1587. doi:10.1093/ajcn/nqy378

[15] Sosa Henríquez M, Gómez de Tejada Romero MJ. Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency. Nutrients. 2020;12(6):1617. Published 2020 May 31. doi:10.3390/nu12061617