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When the Sun isn’t Enough

The exploding body of research regarding the importance of vitamin D has posed a seeming conundrum for health

Minnesota Winter

Minnesota Winter

professionals–adequate levels of vitamin D from the sun versus the critical need for sun protection to protect against the current epidemic of skin cancer.

The assumption in much of this research is that people live in climates where UVB from the sun is available.

But what if they don’t?

An important new study, by Dr. Gregory A. Plotnikoff, in the November edition of Minnesota Medicine, examines this question in the state of Minnesota, where Plotnikoff found that in 2008, fewer than half the days offered enough sun to make vitamin D at noon.

“The bottom line is that in Minnesota, our infamous weather significantly limits our capacity to make vitamin D,” writes Plotnikoff in his study, “Weather or Not: The Importance of Vitamin D Monitoring and Supplementation.”

As science continues to recognize the importance of vitamin D in overall health, vitamin D deficiencies are of increasing concern to clinicians. Vitamin D deficiency is associated  hip fractures, metabolic syndrome, type I and type II diabetes, infectious disease, autoimmune disease, chronic pain, hypertension, and many types of cancer including the deadliest ones.

However, despite our lack of sunny days, Minnesotans do get skin cancers.  In fact, the incidence of diagnosed skin cancers in the state is 18.3 per 100,000 which is higher than the national average of 17.5 of 100,000, according to the National Cancer Institutes.  Moreover, a number of researchers have suggested that intermittent sun exposure may create greater risks for melanoma. For Minnesotans, this means that it is even more important to use sun protection during the warmer months.

Plotnikoff’s study lends credibility to the recommendation by the National Council on Skin Cancer Prevention, that is,  avoid exposure to UVR to help prevent skin cancers and rely on supplements for vitamin D. And, please note that the recommendation focuses on supplements, not food. Very few foods contain vitamin D. And as Plotnikoff point out, “an entire gallon of milk contains less than one-tenth of the vitamin D that one would get by spending an afternoon at the beach.”

Plotnikoff recommends that Minnesota physicians monitor their patients more aggressively for vitamin D deficiencies. “Given the multitude of negative consequences tied to vitamin D deficiency, physicians in Minnesota, much more than their southern colleagues, need to consider monitoring their patients serum vitamin D levels and supplementing appropriately,” he writes.

Dr. Plotnikoff goes on to suggest that “forthcoming evidence will likely support the idea of physicians checking patients vitamin D levels as often as they check their cholesterol levels.”  While some may argue that this is an expensive proposition, it is far less expensive than treating a skin cancer.

The advice contained in the SunAWARE acronym remains valid. “R – Routinely check your skin for suspicious changes and report concerns about skin or sun related issues, including vitamin D, to your health care provider.”

Be SunAWARE and be safe.

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2 Responses to “Vitamin D Deficiencies in Colder Climates”

  1. In order to have an impact on MS incidence (and indeed protect future generations from Type 1 diabetes, Tuberculosis, Rheumatoid arthritis Inflammatory bowel diseases, Systemic lupus erythematosus and brain disorders such as Schizophrenia, Parkinson’s disease, Depression, Epilepsy,) we have to understand the many different roles of vitamin D3 in brain development..

    “Vitamin D, a neuro-immunomodulator: Implications for neurodegenerative and autoimmune diseases.”
    is a recent summary of the current state of knowledge.
    as is this
    “Developmental vitamin D deficiency causes abnormal brain development.”
    these research papers make the point that there are many ways the time in the womb is as, if not more important, than the first 5~6yrs out of the womb while the brain is still developing.

    Having understood the importance of adequate Vitamin 3 status during pregnancy and while breast feeding the question is what is an adequate intake of vitamin D3 to both protect the mothers needs and ensure sufficient is available for the baby.

    Taylor, Hollis and Wagner have detailed this in their work
    “Vitamin D supplementation during lactation to support infant and mother.”
    and from that work we see that to ensure babies are not born vitamin D deficient mothers require at least 6400iu/daily/vitamin D3.

    That ensures the mothers 25(OH)D levels is 58.8ng/ml around 150nmol/l, breast milk is replete with Vitamin D3, and the baby is born with sufficient vitamin D status to maximize calcium uptake from the diet and ensure maximum Bone Mineral Density is achieved from the very start.

    This work was done at latitude 32 (about the same as Jerusalem, and the sun is far more powerful and there is more of it. It is possible higher amounts of D3 will be required at latitude 52.

    “Grassrootshealth D Action”
    offer postal 25(OH)D3 testing at cost price. Effective strength 5000iu/d capsules are cheaper from the USA although they are now available in the UK.

  2. Mary Mills Barrow says:

    Thank you for writing. It is interesting that you note the problem of getting enough vitamin D occurs at the more southern latitudes as well. Again, adding to the case that taking a supplement is important.

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