Doctor Wars-total sunblock vs Vitamin D health?

[Orson]

Vitamin D (just Google or see Wikipedia) deficiency is implicated in general health issues as well as neurological disorders, specifically. Fortunately, sailors work and play outdoors and have lots of opportunities to let their bodies manufacture some from the sun, naturally.

But with more and more people working indoors and the growth of technology discouraging play outside, getting enough of this essential nutrient - virtually a hormone that every cell in the body benefits from it - gaining enough is a thoroughly modern problem. At the same time, we have all heard that we ought to use sunblock to prevent skin cancer all the time. Yet last November, the largest study done on Vitamin D supplements - 25,000 people followed over several years - found no benefit. Maybe, only natural Vit-D from sun exposure gains the benefits expected?

IS SUNSCREEN THE NEW MARGARINE?, January 10, 2016:

Current guidelines for sun exposure are unhealthy and unscientific, controversial new research suggests.... How did we get it so wrong?

This lengthy article from Outside Online covers the debate now raging between the medical societies in a variety of English speaking countries on Vitamin D health benefits versus sunblock to prevent skin cancer, and it may make one reconsider one's current supplementation scheme and sun avoidance.


Me? I go natural in summer, basking in the sun a few times a week without any sunblock. And I still take 4,000 IUs a day in other seasons - it is cheap even if it doesn't work - but maybe I need more direct exposure to the sun?

What do you do, in light of recent medical news like this?

[GordMay]

I live in Canada (North of 48), go "natural" year-round, and take 1,000IU of Vitamin D3 daily. FWIW: I'm dark complected, and tan like a coconut in summer.

[longjonsilver]

i'm 65 and have been fighting gastro and flu each winter, and i live in Canada. Two years ago we went to Florida for a week. My gastro had started in November and i fought it all Dec. In one hour out of the car in Florida, my gastro was GONE and stayed away till about a week after we came home. i realized that Vit D was not enuf (i had been eating as much as 80,000IU a day). There are things that the real sun does besides Vit D. So much for reductionist thinking! i now suntan each WINTER, no matter how cold it is, when the sun is out i get my face into it for 15 mins at least. Yesterday it was minus 16C (4F) and i spent 2 hours in a chair pointed into the sun. Makes me feel great and i have not had ANY gastro, flu or cold symptoms this year. i have only eaten Vit D one day this winter, when we had an extended bout of clouds.

i learned a long time ago that the medical system is ALL about money and NOT about your health. Its not a health care system its a sick care system, and the longer they can keep you sick the more money they make.

[UFO]

Originally Posted by longjonsilver

i learned a long time ago that the medical system is ALL about money and NOT about your health. Its not a health care system its a sick care system, and the longer they can keep you sick the more money they make.

Well said that man

[boatman61]

Dont use sunblock.. just coconut oil or Ambre Soler zero factor to help quick tanning and to keep skin from drying.

[Chotu]

Moderation. I don't purposefully go out in the sun, but I get enough randomly to keep a very small tan. That's enough natural vitamin D without an overdose of UVs to cause cancer or premature aging.

[denverd0n]

My father and grandfather both suffered from melanoma. I have not been diagnosed with a melanoma yet, but I have had enough basal cell, squamous cell, and pre-cancerous bits of skin burned, sliced, or scraped off of my body that skin cancer is a very real, and very serious, concern. I have to balance my need for vitamin D with my desire NOT to die of skin cancer, or have my body completely covered with scars from where various skin cancers have been removed.


I take vitamin D supplements, and I make an effort to get some sun. But I am also very careful about how much sun I get, and very careful NOT to let myself get burned. I very vividly remember the day, some 25 years ago now, when the doctor first looked me in the eye and said, "You have a cancer." It was a sobering moment! And every time since, when a biopsy has come back to indicate a basal cell carcinoma, it is another sobering moment.


So, it is a balancing act. You need to get enough vitamin D, and I do believe that exposure to the sun is necessary to some extent. At the same time, skin cancer is a very real threat, and one that I -- at least -- will never again take lightly.

[Captain Bill]

My experience is purely anecdotal and has no scientific validity, but that being said; I had my first squamous cell carcinoma in 1998 and had one or two squamous or basal cell carcinomas about every 18 months until 2007. My dermatologist suggested that I have my vitamin D checked as low vitamin D levels seemed to be associated with skin cancers in some then recent studies. My Vitamin D level was less than 30% of normal. They put me on all kinds of supplements but nothing raised the level. I noted that I had suffered from GERD for about 20 years and had been taking Prilosec for that condition. Further research I did suggested that Vitamin D absorption requires an acid environment in the stomach and upper portion of the small intestine. Since the Prilosec was suppressing that acid environment I could not effectively absorb Vitamin D. This explained why large doses of oral vitamin D had no effect on my Vitamin D levels. At that point I decided that I would stop using sunscreen and avoiding sun exposure. I did not go out of my way to bath in the sun, but just stopped avoiding it. It was also about the time I retired and actually was doing a lot more outside and developed some tan lines. My Vitamin D level was back in the Normal range in about 6 months and I am now in year 12 without any more skin cancers. I still take Prilosec for GERD. I am not suggesting that anyone not follow their doctors advice, just relating my personal experience. I still have annual checkups at the dermatologist and have the occasional AK frozen off, but nothing has turned to cancer. From 98 to 07 even 6 month checks failed to prevent new cancers from showing up. My uniform on the boat is a pair of shorts and I have a hard top so I get most of my UV from water reflection, and still maintain distinct tan lines. During my cancer years the dermatologist used to tell me how good I was doing because I had no tan lines. Just my experience

[Tornadosailing]

I never use sunblock, haven't for many years, mostly because I'm too lazy to bother. But recently I saw something interesting about sunblock and skin cancer. It seems UVB is the wavelength your body uses to generate Vit D and also is what it responds to when tanning. Sunblock blocks UVB rays. Unfortunately sunblock does a terrible job blocking UVA, which is what causes most skin cancers. This explains why people who use lots of sunblock are also at higher risk for skin cancer. The sunblock gives you the sense that you can stay in the sun longer, and exposes you to more UVA because you're less likely to get out of the sun or cover up, while also suppressing your body's natural response to sun (tanning).

[danielamartindm]

As with most things related to health, moderation makes common sense. There are conflicting memes here. We do need sun/skin-generated Vitamin D, oral dosing with Vitamin D is not efficient, ultraviolet radiation does damage skin and result in premature aging and increased risk of basal cell carcinoma and melanoma, and there is a genetic component that makes one more prone to melanoma. Being sailors, we all likely get enough sun just being on the water for Vitamin D requirements. Personally, I don't seek out "elective" tanning on decks or beaches, I avoid sunburns like the plague, I take a multivitamin that contains Vitamin D, I use 100 sunblock, I cover up when temperature makes it comfortable to do so, and my blood level of Vitamin D is within normal limits. If my bloodwork showed a deficiency, I'd make changes; but my take is, given the proven damage that sun does to skin, I'll keep sun exposure to a minimum as long as my blood work is normal.

[DockDoc]

Ohh man... Can of worms here I come.

We are living organisms developed to live on this thin atmosphered radiation bathed planet. Unless you have xeroderma pigmentosum or albinoism a moderate amount of sun exposure is normal. We all wear 'sunscreen' in varying degrees it's called melanin.
Just like calluses form on your hands and feet from a stimulus "Hey we hands/feet are getting exposed to something rough and damaging we need to thicken up our protective layer", your sun-exposed skin does the same. Increased sun exposure causes increased melanin production. Again just like your hands and feet overexposure leads to damage aka blisters, sun exposure in excess of what your bodies protective mechanisms can absorb leads to damage too. Sunburn and blisters, but over time premature aging and cellular change leading to cancer also are an increasing risk.
If we just listened to our bodies, removed ourselves from the harmful stimulus and allowed our natural protective mechanism to upgrade over time, most of us would be okay. But we think we can go from office lighting in Chicago in January to full sun in Bequai in February and be ok. Lobster anyone?
Sunscreen should be used to protect against overexposure, which varies depending on the person.

Vitamin D, an essential fat-soluble chemical we (used to) get mainly from our diet. Initially it is inactive, it gets exposed to sunlight and becomes a slightly different chemical, but still inactive. It is stored in our cells until needed and activated by our kidneys into an active form, then we call it Calcitriol (just think Calcium Control) and it helps us absorb calcium from our intestine.
You can also get already active Vitamin D in supplement form, no need for sun exposure.
Lack of Vitamin D causes calcium deficiency diseases like Rickets. Remember rickets? Of course not that's because we fortified milk and OJ so rickets went away.
But then the sun became the enemy and moms and dads slathered kids with sunblock, hats and other protective gear, we covered up too. So according to my endocrinology expert (aka my wife), lack of sun exposure in the good ole USA is a major cause of Vitamin D deficiency.
Interestingly Vit D deficiency has been linked to lots of other potential diseases too.
But before you go bake yourself in the cancer-causing radiation of our nearest star, or guzzle gallons of milk, or take tons of Vit D pills remember I said Vit D is fat soluble. Like A, E and K. You can only store so much, and too much is bad for you.
So the long and short, a reasonable amount of sun exposure dependent on your genetically variant baseline melanin production is okay you're literally built for it, It is important to remove oneself before damage occurs (sunburn). Read that again 3 times, please.
If you do not get a sufficient amount of sun, or your diet lacks enough Vit D, a Vitamin D supplement is advised. Your doctor can check your level.
Just like Zinc, Vit C, Blue green algae, yogurt, probiotics, nothing is a cure-all. Americans love their magic bullet medications, so far no such thing.

To all the physicians out there who will read this aghast at the glaring oversimplification, cut me some slack! I'm an ER doc for god sake I have to put this stuff into terms I understand too.
As an aside one area I religiously cover in the sun are my toenails. No real melanin production there and subungual melanoma is a real thing.

[zengirl]

Originally Posted by Orson

Vitamin D (just Google or see Wikipedia) deficiency is implicated in general health issues as well as neurological disorders, specifically. Fortunately, sailors work and play outdoors and have lots of opportunities to let their bodies manufacture some from the sun, naturally.

But with more and more people working indoors and the growth of technology discouraging play outside, getting enough of this essential nutrient - virtually a hormone that every cell in the body benefits from it - gaining enough is a thoroughly modern problem. At the same time, we have all heard that we ought to use sunblock to prevent skin cancer all the time. Yet last November, the largest study done on Vitamin D supplements - 25,000 people followed over several years - found no benefit. Maybe, only natural Vit-D from sun exposure gains the benefits expected?

IS SUNSCREEN THE NEW MARGARINE?, January 10, 2016:



This lengthy article from Outside Online covers the debate now raging between the medical societies in a variety of English speaking countries on Vitamin D health benefits versus sunblock to prevent skin cancer, and it may make one reconsider one's current supplementation scheme and sun avoidance.


Me? I go natural in summer, basking in the sun a few times a week without any sunblock. And I still take 4,000 IUs a day in other seasons - it is cheap even if it doesn't work - but maybe I need more direct exposure to the sun?

What do you do, in light of recent medical news like this?

The body doesn't absorb enough Vit D from the sun for your body to utilize. People over 50 should be taking a Vit D 2,000 a day for optimal health. So use the sunblock to prevent skin cancer and take your daily vit D.

[bcboomer]

Doc

Thank you for an informed, easily understood explanation.

[jackheape]

Lots of interesting viewpoints and anecdotes here. Love it! Just one added point. The medical establishment has to couch everything in very generalistic terms. Everyone is not equal. I tan very easily and do not burn. That is not true for everyone. But... most people are stupid. So if one were to say that moderate sun exposure is ok, everyone would just go out and get burned, including the fair skinned redheads who have no business being out in the sun. I know I feel a hell of a lot better in the summer when I am getting lots of sun than in the winter.

[medevicerep]

For thousands of years, mankind covered their heads while outdoors for extended periods of time. Sunblock and sunscreen are very recent inventions. Spend lots of time outdoors but be smart about it. Cover up when it’s intense but enjoy the sunshine.