
Low Vitamin D:
One Sign of Sunlight Deficiency
A low vitamin D
level found in the blood is one sign of sunlight
deficiency, just like high blood cholesterol is
one sign of eating too much meat and cheese. A
far-reaching campaign has been launched by
doctors, health organizations, supplement
companies, and pharmaceutical industries to fix
the problem of sunlight deficiency with pills.
Take vitamin D pills and the internal levels of
this vitamin will increase, but 5 of 9 studies
have shown no reduction in the risk of suffering
from a fracture and 9 of 10 studies have shown
no decrease in the most serious bone break—hip
fractures.1 In addition, no
reduction in deaths has been found with
supplementation.1 Any hope for
benefit is limited to people with severe
deficiency (levels below 25 nmol/L).* These
pills cost money and the patient becomes
dependent on one more drug. This profile is
analogous to taking “statin”
cholesterol-lowering medications: the
cholesterol plummets, but the risk of heart
attacks in otherwise healthy people remains
unchanged and some people are harmed by the
medication’s side effects.2 Any hope
of benefit is limited to those at very high risk
of heart disease.2 Neither medication
should have been unleashed on the public as a
tonic for better health, yet both have been.1,2
Exposure of the
body to sunshine reduces the risk of cancer and
heart disease, but the use of vitamin D
supplements may increase the risk of both
diseases. Scientific research has shown that
supplements raise the vitamin D levels in a
man’s blood, and increase his risk of prostate
cancer.3 Vitamin D supplements given
to women increase their “bad” LDL-cholesterol
by 4.1%, and reduce their HDL/LDL ratio by
10.5%—changes in both risk factors reflect an
increased risk for heart attack and stroke.4
Sunshine never
causes a toxic overproduction of vitamin D in
the body. However, like all other drugs,
toxicity has been reported with the consumption
of vitamin D supplements as pills and fortified
foods, like cow’s milk.5 The first
sign of toxicity is excess calcium appears in
the urine (hypercalcuria) and then blood levels
of calcium rise (hypercalcemia). Hypercalcemia
over time results in bone loss,
kidney stones, and calcification of organs, like
the heart and kidneys.
Like proper food,
sunshine is essential for life. But, wait a
minute! Aren’t people supposed to stay out of
the sun?
Consequences of
“The No Sun Campaign”
For the past half
century people have been warned to stay out of
the sun—wear protective clothing and use
sunscreens to reduce premature aging of the skin
and prevent skin cancers. The irritating
effects of the sun’s energy may also cause
pterygia (superficial blood vessel tissue on the
whites of the eye) and reactivation of viral
infections, such as lip herpes. There is no
question overexposure should be avoided. But,
have we gone too far with sun avoidance? I,
along with the vast majority of the informed
scientific community, believe so.
The best
recognized consequence of sunlight deficiency is
the bone-deforming children’s disease known as
rickets. This condition is corrected by sunshine
and/or vitamin supplements. A similarly-caused
softening of the bone materials in adults,
accompanied by the loss of minerals, is called
osteomalacia. In most cases, sunlight
deficiency causes no symptoms, but it can
present as diffuse muscle and bone pain, and
weakness, which can be misdiagnosed as
fibromyalgia.6
Sunshine Deficiency May Also Contribute
To: |
Increased
risk of cancer
Poorer
cancer survival
Type-1
diabetes
Decrease
in insulin’s responsiveness
Multiple
Sclerosis
Osteoporosis
Decline in
periodontal attachment (loose teeth)
Cardiovascular disease |
The proposed
benefits of sunlight overlap with those of diet
and exercise. Traditionally, people living
closer to the equator who are exposed to more
sunlight also eat more plant foods; whereas
those living at higher latitudes eat more meat
and dairy products. Most exercise takes place
outdoors (or at least it did until the recent
popularity of health-clubs). Therefore, in
general, more exercise also means more
sunshine. In practical terms, separating the
benefits of sunshine, a plant-food based diet,
and moderate exercise is pointless mental
gymnastics. A health-conscious person will
choose all three.
Sunlight as
Therapy
Sunshine costs
nothing and is effortless. Drawings in ancient
cave dwellings indicate that people understood
the importance of the sun for health, as well as
warmth. During World War I sunlight therapy was
used to heal soldiers’ wounds; and in the years
that followed, hospitals and clinics were built
for treating tuberculosis with sunshine.7
This phototherapy, also know as heliotherapy,
was also prescribed during these times to treat
chronic diseases, such as ulcers, leukemia,
arthritis, gout, and diabetes.8
Recognized Medical Uses of Sunlight:9-19 |
Systemic:
Rickets
Osteomalacia
Psoriasis
Hypertension
High pulse rate
Low HDL-cholesterol
Neonatal jaundice
Pruritis
Psychological:
Premenstrual syndrome
Sleep disorders
Jet-lag
Insomnia
Adult
attention-deficit/hyperactivity
disorder
Mental depression (Seasonal
Affective Disorder)
Skin:
Acne
Alopecia
Atopic dermatitis
Contact dermatitis
Cutaneous T-cell lymphoma
Disseminated granuloma annulare
Localized scleroderma
Urticaria pigmentosa
Pityriasis lichenoides
Pityriasis rosea
Pityriasis rubra pilaris
Pruritis
Urticaria pigmentosum
Vitiligo
|
Ultraviolet light
of the sun’s spectrum has been used for
centuries and is now standard medical therapy,
most commonly prescribed for the debilitating
skin condition psoriasis, and for chronic
depression. Alone or in combination with
medications, like vitamin D and
Psoralen,
ultraviolet-emitting artificial lightings clear
the skin of psoriasis and relieve associated
arthritis. Life-threatening depression,
called seasonal affective disorder, is
successfully treated by exposing patients to
additional ultraviolet light by using “light
boxes.” The benefits of light therapy are
temporary, stopping when the treatment is
discontinued. Please note: the use of natural
sunlight has been found to be superior to the
use of light produced by artificial sources in
both psoriasis and depression.14,15
Sunlight and
Cancer Prevention
Excess sunlight is
a recognized carcinogen, resulting in
precancerous actinic keratosis and squamous and
basal cell skin cancers. More than 1.5 million
skin cancers are diagnosed annually in the US.
Fortunately, these cancers are easy to detect,
are almost never fatal, and are effectively
removed by simple therapies, such Aldara cream,
liquid nitrogen freezing, and laser treatments.
In 1936, Dr.
Peller reported that among US Navy Personnel,
those with frequent skin cancers seemed to
possess immunity to more serious internal
cancers, such as those of the breast, colon, and
prostate.20 Consequently, he
recommended deliberate induction of
(non-melanoma) skin cancers as a “vaccination”
against life-threatening cancers. It is
unlikely that skin cancer provides direct
immunity to other cancers. Rather, the sunlight
itself makes the body healthier and more cancer
resistant.
Worldwide, the
incidence of serious cancers, such as those of
the breast, colon, and prostate, occur less
commonly in geographic latitudes where sun
exposure is greater. Another intriguing finding
is that increased exposure to sunshine improves
survival for people who already have cancer,
including, those of the breast, colon, prostate,
and lung, and melanoma and lymphoma.21-24
Vitamin D Is
Only One Part of the Story
Rather than
focusing on non-profit, self-administered,
non-toxic, highly-effective sunlight, the
money-making spotlight of the medical, research,
and pharmaceutical industries has been on
vitamin D pills. (Similar to the way that
dietary diseases, such as type-2 diabetes and
heart disease, are treated—drug-therapy is the
only game in town.) Apart from vitamin D
synthesis there are a number of known ways that
sunlight can affect a person’s health. Some of
the discovered mechanisms involve the direct
alterations of the immune system, locally and
systemically; modulation of other hormones, like
melatonin, calcitonin, and melanocyte
stimulating hormone; and changing the number and
function of cells present in the skin.8,9
Sunlight also establishes circadian rhythms.
Undoubtedly, many important mechanisms for the
benefit of natural sunlight remain to be
discovered.
Vitamin D Is
Really “Hormone D”
Vitamin D is known
as the “sunshine vitamin,” because it is made by
the action of sunlight on the skin.
Plant-derived sterols found in the skin are
converted by ultraviolet sunlight into vitamin
D. Two further steps occur in the liver and
kidney in order to finalize the production of
the physiologically active form of vitamin D.
Its name comes from the fact that it was
discovered after vitamins A, B, and C. Under
usual circumstances, vitamin D is not a vitamin,
defined as an organic substance which must be
obtained in small amounts from the diet
for growth and health. Rather, this substance
is a hormone made within the body. This
hormone has the rare property of being formed by
ultraviolet light rather than by an enzyme, and
should not be regarded as a nutrient. In real
life, approximately 90% of the vitamin D that
people use is formed within the skin through the
action of sunlight—only 10% comes from diet
and/or supplements.20
The need for sun
precautions these days is because populations
have migrated from their natural environments.
Light-skinned people vacation and live in places
closer to the equator than their ancestors
did—now the direct sunlight exposure is too
intense for their fair skin-type. Dark skinned
people now live in low-sunlight latitudes, wear
cover-up clothing, and work all day inside;
causing sunlight deficiency. The epidemic of
obesity in people of all skin tones has added to
the problem. Because vitamin D is fat soluble,
excess body fat will pull vitamin D out of
circulation thus contributing to deficiency.25
Sunlight is
Quick and Efficient
Most of the
benefits of sunlight, like vitamin D production,
occur within the first 20 minutes of exposure.1
Applying
sunscreen will increase the time requirement for
exposure—but is almost never the cause of
vitamin D deficiency.1
Exposing the body
in a bathing suit to enough sun to make the skin
just begin to turn red (one minimal erythema
dose) is equivalent to ingesting 250 µg of
vitamin D orally.20 (Recommended oral
doses are 50 to 100 µg daily. For conversion
purposes: 1 µg equals 40 IU.) Exposing the face,
arms, and hands of a light-skinned person to 5
minutes of sun at noon two or three times a week
at a latitude of Boston, MA in the spring,
summer, or fall will cause the body to produce
sufficient vitamin D to meet all of its needs.20
This time limit is skin-pigment-dependent.
Asian-Indians may require 3 times, and Blacks
may require 10 times as much exposure, as Whites
under the same sunlight conditions. During
wintertime, people must rely on their fat
stores.
Vitamin D is a fat
soluble vitamin that is stored for long periods
of time mainly in the liver and the fatty
tissues. When a person is completely deprived
of sunlight, such as occurs with people on
submarine missions or people living in extreme
northern and southern latitudes, more than 2
months must pass before half of the vitamin D is
depleted from the fat stores.26 A
sufficiency of vitamin D throughout the year
depends upon how much sunshine a person is
exposed to on his or her summer
vacation—summertime synthesized D being released
from body fat throughout the winter months.27
People who already
have sun damaged areas of skin, such as on their
arms or face, should keep these surfaces
protected. Rather they should expose only
undamaged areas, like their chest, back, abdomen
and legs in order to collect the benefits of
sunshine.
Food and
Supplement Sources of Vitamin D
People following
the typical Western diet and taking
over-the-counter supplements consume less than
25 µg daily. Sufficient levels of oral vitamin
D intake would require at least 50 µg daily.
Therefore, without sunlight exposure, the amount
of vitamin D in the diet and over-the-counter
supplements is typically insufficient to produce
optimal levels.26
Fish, including
salmon, eel, pike, tuna, cod, and herring, have
the highest amounts of vitamin D in their
tissues (averaging 8 µg per 3.5 ounce serving).
This means eating 20 ounces of fish daily to
meet needs—which would also mean eating about
900 calories of fish fat and protein. Farmed
salmon has only 25% of the vitamin D of wild
salmon.28 Egg yolk, beef liver, and
a few plant foods, like wild mushrooms, have
very small amounts of vitamin D. Eight ounces
of fortified cow’s milk or orange juice contains
2.5 µg of added vitamin D. Some cereals and
breads are fortified with vitamin D. A
one-a-day vitamin may contain 10 µg and over-the
counter high potency supplements may contain 25
to 50 µg. Prescription vitamin D supplements are
made from a much more potent form of vitamin D,
with a greater risk of toxicity.
The expected
consequences of eating foods high in calories,
fat, and cholesterol like fish, eggs, beef
liver, and milk would be obesity, type-2
diabetes, and even heart disease. Therefore,
relying on foods for vitamin D runs the very
real risk of making a person sick. Plus,
non-white people who use lactose-containing
dairy products can expect diarrhea, stomach
cramps and gas, due to lactose intolerance.
Should Healthy
People Take Supplements?
No, otherwise
healthy people who can expose themselves to
life-giving sunshine should not bother with
supplements. In addition to missing many
valuable benefits of sunlight, taking
supplements leads to the delusion that “the
problem is solved;” like when people take high
blood pressure, cholesterol and diabetic pills;
they think they are cured.
However, many
people are unable or unwilling to get outdoors.
Lack of information on the importance of
sunlight and the unwillingness to leave their
offices and homes will cause many otherwise
healthy people to get inadequate sunlight. The
elderly and infirm confined to nursing homes,
long-term care facilities, and homes are at high
risk of developing deficiencies. Living above
latitudes of 35 degrees—New York, London,
Moscow, as well as living under
sunlight-blocking air pollution increases the
risk of vitamin D deficiency, especially in the
winter months and for darker-skinned people.
In the above
instances, daily supplementation with 50 to 100
µg of over-the-counter vitamin D will correct
the vitamin D blood level; which is good, but
will not solve the real problem of sunlight
deficiency.
* Circulating
levels of an inactive stable form of vitamin D
(25-OH vit D) measured in the blood is an
accepted indicator of vitamin D status. Normal
in various laboratories is considered 20 to 150
nmol/L. When the lower threshold of normal is
set to 25 nmol/L then 12.2% of US
African-American women are deficient; when the
lower limit is 50 nmol/L then 42.4% are
deficient.1
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