Vitamin D has been in the news recently, with the revelation that half of adults are deficient, and for the first time, many children are now also deficient. Previously, children made lots of this vitamin from the action of sunlight on the skin when they were out playing in the sunshine, but they are now paying the price for their “indoor lifestyle” with their health. So much so, that Government recommendations are to supplement children from the age of one! To add to the problem, there is a lot of confusion about the risk of skin cancer when the skin is exposed to sunshine. So what is the latest thinking about this vitamin, and how can we make sure we get enough without risking skin cancer?
What does Vitamin D Do?
Vitamin D has lots of functions in the body. It plays a critical role in preventing cancer by regulating cell growth, it is essential for healthy functioning of the immune system, it is associated with a reduced risk of cardiovascular disease, and it plays a part in boosting mood and helping with skin conditions such as eczema. It also helps the body absorb calcium, which is important not only for bone health, but also for nerve function and cell membrane function.
Sources of Vitamin D and the Skin Cancer Debate
Although vitamin D is found in oily fish, eggs, mushrooms and liver, we were designed to obtain it primarily from UVB rays in sunshine. Unfortunately, it is not just our indoor lifestyle that is thwarting our intake though: our phobia about sunshine and skin cancer means that we often apply SPF cream before even going out, which prevents the skin making vitamin D. Current advice, however, is to expose unprotected skin to the sun for about half the time it takes to burn, and then cover up or apply an SPF cream. Remember that vitamin D helps to prevent cancer, so allowing the skin to make some is a good thing! What isn’t ever a good idea, though, is to allow your skin to burn, because of the increased risk of malignant melanoma. And babies should never be exposed to direct sunlight because their skin is so delicate. In fact, they should get their vitamin D solely from breast or formula milk.
Here at Springwell Clinic, we understand that you may want to minimise the effect of the sun on ageing of the skin, so we recommend that you apply an SPF of at least 50 to the face, apply it before going out in the sun and reapply every two hours, and allow the arms and legs to be remain exposed for a while without burning.
The fact remains, though, that very few people in the northern hemisphere are able to expose enough of their skin to strong enough sunlight for long enough, which is why it is a good idea to consider supplementation. Start with at least 2000 IU per day of vitamin D3, which is the easily converted into its active form, and then after six months, have your blood level tested (you can buy a home test online for less than £30 if your doctor is reluctant to do this for you). Although 2000 IU might sound like a lot, the body can make 10,000 to 25,000 IU in less time than it takes for the skin to burn. The ideal blood level range is between 50 and 70 ng/ml.
Some people would be better to start with 3000 IU. Older people have a harder time making vitamin D from sunshine, and they may also be more inclined to stay indoors more, so they may need higher levels of supplementation. Obesity is also an indicator for a higher level, because body fat collects and stores the vitamin. Darker skins also make less vitamin D, because the pigment acts as a natural sunscreen to the UVB rays.
Signs of Deficiency
Since this vitamin is so important for healthy function of the immune system, deficiency symptoms include frequently succumbing to infections, including flu, and impaired wound healing, as well as the presence of autoimmune diseases, such as inflammatory bowel disease and multiple sclerosis. And since vitamin D helps the body absorb calcium which is critical for bone health, cell and nerve function, deficiency symptoms may manifest as aching bones, fatigue, depression and muscle pain (often diagnosed as fibromyalgia) as well as head-sweating from neuromuscular irritability. Insufficient vitamin D is associated with not only an increase in heart attacks, but in increased risk of death from a heart attack.
Signs of Toxicity
Toxicity is very uncommon! Blood levels greater than 150 ng/ml are considered toxic and would typically be achieved by supplementing a colossal 40,000 IU per day for a couple of months or more. Signs of toxicity included poor appetite, nausea and vomiting, muscle weakness and kidney problems, including frequent urination. Supplements need to be stopped immediately and only cautiously re-established when blood testing shows levels have returned to an optimal level.
Our Advice at Springwell....
In summary, we recommend that you apply SPF 50 to the face, allow your arms and legs to get some sunshine without running the risk of burning, take a D3 supplement of at least 2000 IU per day and get your blood level tested regularly. That way, you’ll minimise the harsh effect of the sun ageing your skin without becoming vitamin D deficient!