But doc? Don’t I need to be in the sun to get Vitamin D? This question often starts off the discussion about sun exposure and Vitamin D. Many patients seem to be using Vitamin D needs as a reason to bronze themselves to tan leather each summer. As a dermatologist, my recommendations need to balance the health needs of Vitamin D with the adverse effects of UV exposure.
Vitamin D: What is it?
Vitamin D is one of four fat-soluble vitamins, Vitamin A, D, E, and K. Some vitamins are water-soluble, and others are fat soluble. The important differentiation is that we cannot overdose on water-soluble vitamins, but there is a limit to the number of fat-soluble vitamins we should consume. When I was in medical school, Vitamin D was only mentioned in the form of Rickets, a severe form of Vitamin D deficiency. In the past 20 years, the role of and discussion about Vitamin D has expanded to include almost every organ system in the human body. Checking and improving Vitamin D levels has become a routine part of management in hundreds of medical conditions and yearly physicals. So, now more than ever, I feel a need to encourage my patients to obtain Vitamin D while maintaining healthy skin. Studies show that at least 40% of Americans are deficient in Vitamin D and this is much higher in my home state of West Virginia where it can be quite dreary at times.
Vitamin D: What role does sun exposure play in healthy Vitamin D levels?
Vitamin D can generally be obtained in three ways, food, supplements, and sun exposure. In foods, Vitamin D is found primarily in fatty fish, eggs, cheese, fortified dairy, and Vitamin D2 in wild mushrooms. YUM! The Recommended Daily Allowance (RDA) is 400-800IU. But of course, everyone’s favorite way to get Vitamin D is through sun exposure. People often ask me how long and how much sun exposure is needed to maintain healthy Vitamin D levels. This can be affected by many factors: time of day, where you live, the color of your skin and the amount of skin you expose. Regarding Vitamin D synthesis, the most effective exposure would be your whole body at noon on the equator. Not practical.
The recommendations are all over the place, but what we do know is that UVB rays are required for the body to convert cholesterol in the skin to Vitamin D. Some studies suggest that 5-30 minutes of sun exposure at midday is enough to allow sufficient Vitamin D synthesis. However, all UVB exposure also damages the skin increasing the lifetime risk of skin cancer. There is no possible way of increasing Vitamin D levels through sun exposure without also increasing the lifetime risk of skin cancer.
Vitamin D: How vitamin D deficiency adversely affects the body?
Vitamin D deficiency has been linked to Osteoporosis, Cancer, Depression. It is believed that Vitamin D deficiency plays the strongest role in colon, prostate and breast cancer, but has also been shown to play a role in diabetes and other multisystem disorders. In the skin, the role of Vitamin D has been investigated in many skin disorders, and topical Vitamin D has been used to treat psoriasis. In hair loss, vitamin D deficiency can be linked to telogen effluvium.
In any case, maintaining adequate healthy levels of Vitamin is important at all ages. Daily supplementation with Calcium + Vitamin D and enjoying Vitamin D fortified foods is the simplest way to maintain both. Unfortunately, in West Virginia, fresh fatty fish and UVB exposure aren’t practical ways to raise those Vitamin D levels. If you are concerned about your Vitamin D levels, I recommend getting your levels checked and monitored by your primary care physician who can also instruct and prescribe Vitamin D supplementation in severe cases.
Theresa Hill shares a healthy recipe for chewy date bars. Dates and hemp are both high in calcium with aides in Vitamin D absorption.
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