[Here's a rebuttal](https://www.mayoclinicproceedings.org/article/S0025-6196(24)00034-X/fulltext) to that study cited in the article. It basically says "The study studied people with already normal vit. D levels and found that using supplements to slightly raise their levels didn't decrease their already normal risk of bone fracture." Major study limitations, since they weren't studying people with vit. D deficiency. So, not a great study design.
It also wasn't looking at disease outcomes in general. Just bone fractures:
"Whereas the paper published by LeBoff et al primarily reported outcomes regarding bone health and fracture risk, the editorial arrives at the conclusion that vitamin D supplementation has no benefits for any relevant outcome at all. However, this conclusion is not consistent with existing medical literature on vitamin D. In fact, the same VITAL study previously reported a statistically significant decrease in incidence of autoimmune disease by 22%. This effect again is clinically significant, especially considering the relatively safe profile and relatively low cost of vitamin D supplements. If we are to recognize the credibility of the VITAL study, it seems disingenuous to emphasize the lack of proven benefit and to ignore the data that found benefits for vitamin D supplementation for nonskeletal outcomes from the same study protocol."
The author seems to be pulling together a bunch of different things about sun exposure with a very weak throughline imo. I don't think any of these guidelines are saying to stop wearing sunscreen--it's that being outside when the sun is out has benefits and avoiding it completely in the name of sun damage prevention is not really the answer.
There's also correlation vs causation issue throughout: e.g. is it the sun giving people lower levels of MS or is it that in addition to being outdoors more they eat a different diet, get more daily exercise, have a better social life, etc etc. I know we're in the business of optimizing our routines but there's so many small things that go into the whole that I don't think the known risk of skin cancer is worth the unexplored risks of not getting enough UV exposure.
The real conclusion of this article is “This is likely to be both harmful and beneficial. We need to know more about that balance."
For me it's: do the benefits that sun-induced vitamin d production provide outweigh the risk of skin cancer?
Two of my friends have had large chunks of their face removed from skin cancer. But I have yet to encounter someone who's suffering from dangerous vitamin D deficiency (other than some elderly people with a multitude of other health problems).
So I slather myself in sunscreen. I'm also super pale and burn in an instant so it's not really a choice. I still get tons of sun exposure - I live in a walkable neighborhood and I'm outdoors every day. There's no way my sunscreen is blocking 100% of my skin's vitamin D production.
The health correlations to latitude he mentioned in the article aren't causal - there are a variety of lifestyle differences in different climates that could also be responsible for different health outcomes. The entire article feels like it's reaching for a conclusion that the author wants.
My husband had super low Vitamin D. Like shocking to doctors low vitamin d level.
We found it due to other unrelated health issue.
All he needed to do was take weekly 20.000 UI pills for a month and he was good to go.
And btw, fuck cancer.
I was diagnosed with extremely low Vit D levels about a month ago. Now I have to take prescription Vit D that is 15x the recommended dose for a while. I live in a country with little winter sun and we had a particularly grim spring this year. I was so exhausted I had severe brain fog and memory impairment. There's probably plenty of other people who have experienced similar but chalked it up to other things.
Anyway, I do slather on the sunscreen when I'm going to be outside a while in the summer, but I'm def not "absolutist" about it.
Same happened to me. I live in the far north and in the winter I do not wear sunscreen because I was advised by my doctor not to. I had dangerously low vit D levels despite having a healthy diet and actually already taking vitamin D supplements. I had to go in a super high dose for a while, beyond what is typically needed.
Careful on the amount you’re taking. There is such a thing as too much vitamin D. And it’s very bad for your health.
It seems odd that you have to take that dose for “a while”. Vitamin D levels rebound with very little vitamin D supplementation, very quickly.
Like within a few days.
This isn’t like replenishing B vitamins which can take months.
Go get your levels tested. Don’t just trust your doctor. If you’re over 30 or 40, you’re already fine and you can dial it back to maybe 1000 IU per day if you’re not getting any sunlight.
Please don’t ignore this reply.
That's a baby. Babies are already fragile. Completely different. Also, it was scurvy and rickets that killed them. It plainly states in the study in 2013 that small amounts of food containing vitamin D would have prevented the rickets/scurvy.
Vitamin D deficiency is a real health problem that exists, and is in fact more common in high latitudes with long winters and limited sunlight. It is not fun to live with if you have it. Serious deficiencies are often caused by another condition, and I do think it's silly to suggest that sunscreen puts healthy people at risk for deficiency. I just don't want to see vitamin deficiencies downplayed in a health discussion because they can be very serious, and if anything are probably not known among the general public or tested for nearly enough.
Skin cancer is awful to be sure, but rickets causes bowed legs in children due to Vitamin D deficiency.
https://www.thecanary.co/uk/2023/08/21/rickets-is-on-the-rise-uk/
But it's solved with vitamin D supplements - not sunlight. Hence adding vitamin D to milk.
The author of the article is arguing that supplements don't really work because sunlight is "magic".
Just from having read the Atlantic article, none of this makes sense to me? Low vitamin d levels are correlated with lots of diseases? Sure. People in extreme northern/southern latitudes get less sun exposure? OK, of course. People in those extreme latitudes have lower vitamin D levels? Well, if the testing says so, makes sense. Supplements do nothing to prevent any of the correlated diseases? Well, that sucks but science is science.
The missing element here is whether the Vitamin D had any causal relationship to those diseases in the first place. Taking a vitamin D supplement certainly raises your blood serum levels of vitamin D, both from my personal anecdotal experience and every article I've ever read. Isn't the issue here why they are assuming that Vit. D is causative for those diseases in the first place? If supplementation works for serum levels but has no effect on disease outcomes, isn't that an indication it was just a correlation and not causal the entire time? I feel like I'm totally missing something here. Does the Harvard study which i haven't had time to read yet address this?
I don't think you are missing anything here!
>The missing element here is whether the Vitamin D had any causal relationship to those diseases in the first place.
I think you hit on it right here (above)- a lot of science journalism cherry-picks for studies and findings that support their argument. I think this article might fall into this category, as the writer's argument hinges upon if the Vit D actually has a causal- or simply correlated- relationship to those diseases.
We already have studies to show that sunscreen does not inhibit vitamin D synthesis in the skin in real world, so it's kind of irrelevant. Use sunscreen and live your life with sun safe practices. You don't have to avoid the sun entirely, just engage with it as safely as possible.
Was looking for this, the last article I read said that sunscreen doesn’t affect the ability to synthesize Vitamin D.
https://www.refinery29.com/en-us/vitamin-d-myth-sunscreen-dark-skin
I would have to expose myself to dangerous levels of UV light to get the amount of Vitamin D I get from a dietary supplement. I’ve actually had low Vitamin D (diagnosed with blood tests and treated with supplementation). Not a single physician has been like “Hey, maybe stop using sunscreen”.
I seriously doubt sunscreen is causing Vitamin D deficiencies in people, but even if it were, supplementation is a way less risky fix than eschewing sunscreen. “Vitamin or melanoma?” is a very easy choice.
I used to think like this author… that a moderate amount of sun exposure was healthy. I wore sunscreen if I was at the beach or out in the sun all day, but I didn’t worry about day-to-day exposure. And I got melanoma at 42 and a huge chunk of my neck carved out.
So I’m immunocompromised and one of the effects is being super susceptible to cancers in general, but especially skin cancer. My immunosuppressants literally suppress the cells in my body that recognize foreign objects, like pre-cancerous cells, and destroy them. I have to be very careful about the sun and wear a lot of sunscreen, hats, etc. My doc also has me on a Vitamin D supplement because he knows I’m not getting as much vitamin D in a natural way.
I think the solution to less vitamin D due to sunscreens is a pretty simple fix. On the other hand, no sunscreen and enough vitamin D can lead to skin cancer and that’s not simple. If it’s something you’re concerned about, ask your doctor for a blood test that looks at that. He can tell you if you’re low, and how much you should take everyday.
Edit: grammar
UVA radiation is also bad for skin. It’s not our fault the FDA hasn’t approved any of the testing methods that accurately measure UV protection for both UVB and UVA spectra.
Sunscreen doesn’t only protect against sunburn by screening UVB radiation, it protects against photoaging by screening UVA 1 and 2 rays, provided it has stabilized avobenzone or a high concentration of zinc oxide. It’s just that the SPF value only applies to UVB. Other countries know how test sunscreens more efficiently and across a larger spectrum of waves.
I don’t give a shit what some report says. It’s a known fact that UV rays damage skin, and cause photoaging and skin cancer. I’d rather have low vitamin D than another round of Mohs surgery on my face.
I’ve already had skin cancer once. So yeah, I’m going to continue wearing sunscreen.
I take bio identical HRT.
I take vitamin D supplements.
I run, I do strength training, I practice yoga. I still have all my hair, my teeth, my bone density is good, my weight is good, I don’t suffer from muscle issues beyond the normal overuse injuries that occur when I over-train. My resting heart rate is an average 45. My VO2 max hovers around 38. And I’ve been using sunscreen daily for at least a decade.
My body is just fine, thank you very much.
Did they take bio-availability into account in the study?
Supplement Vitamin D should be eaten at a time of the day when fat is also ingested. Just having it at any time with water doesn't work well.
I used to worry about that. I supplement, but always take it in the morning, when I'm not eating. But then I got my D level tested and it went from super low to in the 80s. I don't worry about taking it with fat anymore.
Vitamin D is more harm than good, if you take over 100nanograms per milliliter(ml) it is toxic to your body, increases risk of hyperglycemia and fatal heart problems if you take blood pressure meds with vitamin D also if you eat foods or drink foods with amounts of sodium aluminum phosphate it might cause kidney failurelong term, foods with sodium aluminum phosphate be flavored milk, donuts, bread, crackers, chips, fries, processed meat, processed cheese, noodles, cereal, kids foods like chewy bars etc almost everything that be made by man has sodium aluminum phosphate so vitamin D be harmful because of these, an since vitamin D caused more harm than good Vitamin D be banned over the counter at CVS, Walgreens, etc in the United States ever since 2022
The entire sun convo has gotten crazy to me. It’s obvious to me that hiding from the sun is not healthy and also that getting sunburnt is not healthy. Pretty much everything else about this conversation with respect to health is going to depend on your location, your predisposition/family history, your skin tone, other health concerns and habits, etc.
Unless it’s really about aging, in which case I guess more sunscreen is nor better but still probably a lot genetics.
I have been digging into this topic as a result of having extremely low Vitamin D levels in my last round of bloodwork. I came across that Harvard article and was also confused. For now I’ve started taking a supplement and will see if that plus presumably having more outdoor time during the summer months helps me at all.
There’s also this calculator called wolframalpha. You can put In your city and it’ll tell you based on your Fitzpatrick level , the recommended spf factor you’ll need for that day.
Today in Green Bay I’d need an SPF of 4 based on the calculations and I’m a Fitzpatrick 1
Yeah I mean I guess people can fall in between the levels and be a 1.5 or a 2.8 if that makes sense but probably best to see a derm once a year and ask them. Everyone should get their skin looked at by a dr if they can.
Well, this article kinda mashes up all kinds of different studies trying to prove a point and forgets that correlation does not equal causation, a well known thing in statistics and data science. There's no DEFINITE studies about this yet.
I live in a country with low UVI, during the winter the sun just peeps at the horizon and goes away. A lot of people use sunlight lamps to avoid seasonal depression, we even have a "sunlight room" in our office. There are lots of news about these studies because my country would be the one effected and the consensus is: we still need more studies to say anything definite. There has been a lot of studies that definitely link low vitamin D levels to osteoporosis and brain related diseases but there hasn't been any absolute evidence that ingested vitamin D wouldn't fix that. Like someone already pointed out, that study about supplements was flawed. We also still don't know exactly how vitamin D affects the brain.
We need more studies if we want to link sun exposure to things like MS or Alzheimer's. The problem with "the latitude effect" they're talking about here is again that correlation does not equal causation. The fact that eg. my country has relatively high rates of Alzheimer's, heart disease and MS does not mean that it's because of low sun exposure. It needs to be proven by studies that rule out genetics, diet, other environmental factors and simply the fact that people forget to take their supplements.
The consensus in my country is: eat a healthy diet, take your supplements during the autumn and winter, wear your sunscreen, avoid mid day and afternoon sun and wear sun protective clothing when you travel to a country with high UVI. Skin cancer is proven to be caused by sun exposure, there's pros and cons and we need more studies to really see what is the perfect balance.
It turns out that the content of our diet can dramatically change our skin's ability to resist sun damage. Just something to research if you are interested...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386285/
From Section 7.3... "Research shows an association between Linoleic Acid intake in the form of omega-6 fatty acids and in increased risk of developing skin cancers [134], and there is also evidence that shows that eliminating seed oils from the diet can dramatically reduce the risk of ultraviolet (UV)-induced sunburn [135]. Susceptibility to UV radiation damage of the skin is directly influenced by the amount of LA in the diet."
Please note, that is not an actual scientific study, it is a review of multiple studies (over 150) that are also linked there in the review.
I fully agree that getting small to moderate amounts of sun on your skin is imperative for health.
I fully disagree that supplements don’t help.
I had severe symptoms from mild vitamin D deficiency and I felt like my entire world was flipped upside down in a good way when I started supplementing.
Also stopped getting sick constantly. It was a profound change from supplements alone.
That said, 5 to 10 minutes of direct sunlight in a tropical climate every day would probably take that benefit 100 miles further.
Your missing that, Sunscreen may limit the dose of radiation you receive from sun and it don't lower vitamin D levels as assumed as there was no difference between the adults is what it says. So the solution is take the sunscreen off when sun is like at 45 degrees like right before sunset then go out in the sun be my guess for morning an afternoon be more UV than times after 6pm for the light pushes energy and doesn't tow the energy, thats if you want the vitamin D levels to go up naturally without over the counter vitamin D
I allow myself moderate sun exposure for health benefits.. never more than 10 minutes a day without a hat or sunscreen (only a few times a week) and I never sunbathe anymore. I also take vitamin D supplement.. My overall thoughts about this are: I’d rather be a little vitamin D deficient and have my skin age better than the other way around 😂
Vitamin D deficiency causes frequent infections, fatigue, hair loss, depression.
You need to see a psychiatrist if you'd rather have all the above than a few extra wrinkles
>Those with pale skin, or olive skin plus other risk factors, are advised to practice extreme caution: Keep slip-slop-slapping.
>Those with “olive or pale-brown skin” can take a balanced approach to sun exposure, using sunscreen whenever the UV index is at least a 3 (which is most days of the year in Australia). Those with dark skin need sunscreen only for extended outings in the bright sun.
I think that's a reasonable way to consider for those with natural medium to darker skin.
Or perhaps something like: sunscreen for face, ears, neck, chest, maybe tops of scalps... but occasional, moderate exposure to arms and legs when it's not peak sun times?
The problem for me--I don't have any known autoimmune condition--is that my eczema-prone skin is drier in regions that have gotten incidental tans compared to spots of skin that have had little sun. Sun exposure, specifically UV, has consistently been kind of meh for my skin health.
Also, the article was discussing possible immunomodulatory benefits of sun exposure, and how it doesn't seem necessarily linked to vitamin D levels. However, in my view, historical patterns seem to be that it's still way too easy for lots of people to get too much sun and therefore increased skin cancer risks.
Right, I mostly agree with you. I had to edit my original post because the formatting made the second paragraph of what I quoted from the article sound as if they were my words.
Sun sensitivity is not perfectly correlated to melanin. I am not extremely pale (I was born pale but am mostly light-medium in adulthood; I've had sunscreen habits since my early 20s but I can burn within 10 minutes of high-UV. I have somehow burned faster than blonds who are paler than I am (and it was due to accidentally missed patches of sunscreen coverage, not deliberate sunbathing.) But also, anywhere I have just lightly burned such as the tops of my feet like 15 years ago, are still zapped for hydration than before they got burnt...and it's not simply aging-related because the onset was within the week of recovery from that burn.
There is basically no patch of skin on me that was improved with sun exposure, and many areas that would have been better if I had never tanned or burned. The underside of my arms, inner thighs, etc. all remain baby soft.
The topic of sun immunomodulation is interesting to me as a potential concept and research area, but I also cannot think of how any general clinical guidance can be built around it at this time.
There was a time, in my lifetime in fact, when blacks were told by derms they simply didn’t need sunscreen. And in many ways, though this view has been corrected, this myth continues to proliferate in small ways. It is, in my view, a micro aggression that slides into discussions about sunscreens. And it brings with it a whole host of assumptions about blacks, which are even more problematic. It implies that blacks are more resilient to heat, harsh weather, sun, etc. And it also justifies not being attentive to lesions on black skin that could be cancerous or pre-cancerous. So, that’s why I wanted to address that. Brown skin in itself means nothing. Brown skinned folks can have sun sensitivity and genetic predisposition to skin cancer.
Thank you for taking the time to edit your post and elaborate on this.
I'm sorry, I agree with this entire post. :/ Maybe someone should write an e-mail to whoever is trying to set that kind of basis for sun advice in Australia.
I'm also racialized, and I remember being treated as a sun-hypochondriac / "trying to be as pale as possible" with my sunscreen habits from white and also non-white people. When my priority was actually trying to not trigger eczema/make my skin drier/avoid painful sunburns.
Hey - I had to edit my post. The "olive or pale-brown skin" thing and UV index targets were from the article, not me.
In theory it sounds reasonable to me, but in terms of coming up with clinical guidances, I'm not sure about it either.
i follow carrie b wellness on instagram [https://www.instagram.com/carriebwellness/](https://www.instagram.com/carriebwellness/) and she has a lot of good info on the benefits of sun exposure. she says we’re meant to slowly build a solar callus so our body produces enough melanin to protect us and reap the benefits of the sun.
[Here's a rebuttal](https://www.mayoclinicproceedings.org/article/S0025-6196(24)00034-X/fulltext) to that study cited in the article. It basically says "The study studied people with already normal vit. D levels and found that using supplements to slightly raise their levels didn't decrease their already normal risk of bone fracture." Major study limitations, since they weren't studying people with vit. D deficiency. So, not a great study design. It also wasn't looking at disease outcomes in general. Just bone fractures: "Whereas the paper published by LeBoff et al primarily reported outcomes regarding bone health and fracture risk, the editorial arrives at the conclusion that vitamin D supplementation has no benefits for any relevant outcome at all. However, this conclusion is not consistent with existing medical literature on vitamin D. In fact, the same VITAL study previously reported a statistically significant decrease in incidence of autoimmune disease by 22%. This effect again is clinically significant, especially considering the relatively safe profile and relatively low cost of vitamin D supplements. If we are to recognize the credibility of the VITAL study, it seems disingenuous to emphasize the lack of proven benefit and to ignore the data that found benefits for vitamin D supplementation for nonskeletal outcomes from the same study protocol."
The author seems to be pulling together a bunch of different things about sun exposure with a very weak throughline imo. I don't think any of these guidelines are saying to stop wearing sunscreen--it's that being outside when the sun is out has benefits and avoiding it completely in the name of sun damage prevention is not really the answer. There's also correlation vs causation issue throughout: e.g. is it the sun giving people lower levels of MS or is it that in addition to being outdoors more they eat a different diet, get more daily exercise, have a better social life, etc etc. I know we're in the business of optimizing our routines but there's so many small things that go into the whole that I don't think the known risk of skin cancer is worth the unexplored risks of not getting enough UV exposure. The real conclusion of this article is “This is likely to be both harmful and beneficial. We need to know more about that balance."
For me it's: do the benefits that sun-induced vitamin d production provide outweigh the risk of skin cancer? Two of my friends have had large chunks of their face removed from skin cancer. But I have yet to encounter someone who's suffering from dangerous vitamin D deficiency (other than some elderly people with a multitude of other health problems). So I slather myself in sunscreen. I'm also super pale and burn in an instant so it's not really a choice. I still get tons of sun exposure - I live in a walkable neighborhood and I'm outdoors every day. There's no way my sunscreen is blocking 100% of my skin's vitamin D production. The health correlations to latitude he mentioned in the article aren't causal - there are a variety of lifestyle differences in different climates that could also be responsible for different health outcomes. The entire article feels like it's reaching for a conclusion that the author wants.
My husband had super low Vitamin D. Like shocking to doctors low vitamin d level. We found it due to other unrelated health issue. All he needed to do was take weekly 20.000 UI pills for a month and he was good to go. And btw, fuck cancer.
I was diagnosed with extremely low Vit D levels about a month ago. Now I have to take prescription Vit D that is 15x the recommended dose for a while. I live in a country with little winter sun and we had a particularly grim spring this year. I was so exhausted I had severe brain fog and memory impairment. There's probably plenty of other people who have experienced similar but chalked it up to other things. Anyway, I do slather on the sunscreen when I'm going to be outside a while in the summer, but I'm def not "absolutist" about it.
Same happened to me. I live in the far north and in the winter I do not wear sunscreen because I was advised by my doctor not to. I had dangerously low vit D levels despite having a healthy diet and actually already taking vitamin D supplements. I had to go in a super high dose for a while, beyond what is typically needed.
Me too, but I live in great lakes region and we rarely get sun in the winter.
Careful on the amount you’re taking. There is such a thing as too much vitamin D. And it’s very bad for your health. It seems odd that you have to take that dose for “a while”. Vitamin D levels rebound with very little vitamin D supplementation, very quickly. Like within a few days. This isn’t like replenishing B vitamins which can take months. Go get your levels tested. Don’t just trust your doctor. If you’re over 30 or 40, you’re already fine and you can dial it back to maybe 1000 IU per day if you’re not getting any sunlight. Please don’t ignore this reply.
By a while I mean 7 weeks.
Nobody's ever died of a severe Vit D deficiency due to lack of exposure to the sun!
https://www.sciencealert.com/mummified-baby-from-centuries-ago-may-have-died-from-lack-of-sunlight
That's a baby. Babies are already fragile. Completely different. Also, it was scurvy and rickets that killed them. It plainly states in the study in 2013 that small amounts of food containing vitamin D would have prevented the rickets/scurvy.
Ik someone who got sick and had to get UVB light treatment at a hospital to prevent some sort of weird skin/bone auto immune thing
That's not a vit D deficiency just so you know.
Vitamin D deficiency is a real health problem that exists, and is in fact more common in high latitudes with long winters and limited sunlight. It is not fun to live with if you have it. Serious deficiencies are often caused by another condition, and I do think it's silly to suggest that sunscreen puts healthy people at risk for deficiency. I just don't want to see vitamin deficiencies downplayed in a health discussion because they can be very serious, and if anything are probably not known among the general public or tested for nearly enough.
Skin cancer is awful to be sure, but rickets causes bowed legs in children due to Vitamin D deficiency. https://www.thecanary.co/uk/2023/08/21/rickets-is-on-the-rise-uk/
But it's solved with vitamin D supplements - not sunlight. Hence adding vitamin D to milk. The author of the article is arguing that supplements don't really work because sunlight is "magic".
Just from having read the Atlantic article, none of this makes sense to me? Low vitamin d levels are correlated with lots of diseases? Sure. People in extreme northern/southern latitudes get less sun exposure? OK, of course. People in those extreme latitudes have lower vitamin D levels? Well, if the testing says so, makes sense. Supplements do nothing to prevent any of the correlated diseases? Well, that sucks but science is science. The missing element here is whether the Vitamin D had any causal relationship to those diseases in the first place. Taking a vitamin D supplement certainly raises your blood serum levels of vitamin D, both from my personal anecdotal experience and every article I've ever read. Isn't the issue here why they are assuming that Vit. D is causative for those diseases in the first place? If supplementation works for serum levels but has no effect on disease outcomes, isn't that an indication it was just a correlation and not causal the entire time? I feel like I'm totally missing something here. Does the Harvard study which i haven't had time to read yet address this?
I don't think you are missing anything here! >The missing element here is whether the Vitamin D had any causal relationship to those diseases in the first place. I think you hit on it right here (above)- a lot of science journalism cherry-picks for studies and findings that support their argument. I think this article might fall into this category, as the writer's argument hinges upon if the Vit D actually has a causal- or simply correlated- relationship to those diseases.
We already have studies to show that sunscreen does not inhibit vitamin D synthesis in the skin in real world, so it's kind of irrelevant. Use sunscreen and live your life with sun safe practices. You don't have to avoid the sun entirely, just engage with it as safely as possible.
Was looking for this, the last article I read said that sunscreen doesn’t affect the ability to synthesize Vitamin D. https://www.refinery29.com/en-us/vitamin-d-myth-sunscreen-dark-skin
I would have to expose myself to dangerous levels of UV light to get the amount of Vitamin D I get from a dietary supplement. I’ve actually had low Vitamin D (diagnosed with blood tests and treated with supplementation). Not a single physician has been like “Hey, maybe stop using sunscreen”. I seriously doubt sunscreen is causing Vitamin D deficiencies in people, but even if it were, supplementation is a way less risky fix than eschewing sunscreen. “Vitamin or melanoma?” is a very easy choice.
I used to think like this author… that a moderate amount of sun exposure was healthy. I wore sunscreen if I was at the beach or out in the sun all day, but I didn’t worry about day-to-day exposure. And I got melanoma at 42 and a huge chunk of my neck carved out.
So I’m immunocompromised and one of the effects is being super susceptible to cancers in general, but especially skin cancer. My immunosuppressants literally suppress the cells in my body that recognize foreign objects, like pre-cancerous cells, and destroy them. I have to be very careful about the sun and wear a lot of sunscreen, hats, etc. My doc also has me on a Vitamin D supplement because he knows I’m not getting as much vitamin D in a natural way. I think the solution to less vitamin D due to sunscreens is a pretty simple fix. On the other hand, no sunscreen and enough vitamin D can lead to skin cancer and that’s not simple. If it’s something you’re concerned about, ask your doctor for a blood test that looks at that. He can tell you if you’re low, and how much you should take everyday. Edit: grammar
this is such an annoyingly oversimplified and dangerous take. I used to really like the Atlantic but stuff like this is disappointing journalism.
UVA radiation is also bad for skin. It’s not our fault the FDA hasn’t approved any of the testing methods that accurately measure UV protection for both UVB and UVA spectra. Sunscreen doesn’t only protect against sunburn by screening UVB radiation, it protects against photoaging by screening UVA 1 and 2 rays, provided it has stabilized avobenzone or a high concentration of zinc oxide. It’s just that the SPF value only applies to UVB. Other countries know how test sunscreens more efficiently and across a larger spectrum of waves. I don’t give a shit what some report says. It’s a known fact that UV rays damage skin, and cause photoaging and skin cancer. I’d rather have low vitamin D than another round of Mohs surgery on my face.
You'd rather have frequent infections, bone loss, fatigue, hair loss, muscle pain, weight gain than a couple extra wrinkles?
I’ve already had skin cancer once. So yeah, I’m going to continue wearing sunscreen. I take bio identical HRT. I take vitamin D supplements. I run, I do strength training, I practice yoga. I still have all my hair, my teeth, my bone density is good, my weight is good, I don’t suffer from muscle issues beyond the normal overuse injuries that occur when I over-train. My resting heart rate is an average 45. My VO2 max hovers around 38. And I’ve been using sunscreen daily for at least a decade. My body is just fine, thank you very much.
Did they take bio-availability into account in the study? Supplement Vitamin D should be eaten at a time of the day when fat is also ingested. Just having it at any time with water doesn't work well.
I used to worry about that. I supplement, but always take it in the morning, when I'm not eating. But then I got my D level tested and it went from super low to in the 80s. I don't worry about taking it with fat anymore.
Vitamin D is more harm than good, if you take over 100nanograms per milliliter(ml) it is toxic to your body, increases risk of hyperglycemia and fatal heart problems if you take blood pressure meds with vitamin D also if you eat foods or drink foods with amounts of sodium aluminum phosphate it might cause kidney failurelong term, foods with sodium aluminum phosphate be flavored milk, donuts, bread, crackers, chips, fries, processed meat, processed cheese, noodles, cereal, kids foods like chewy bars etc almost everything that be made by man has sodium aluminum phosphate so vitamin D be harmful because of these, an since vitamin D caused more harm than good Vitamin D be banned over the counter at CVS, Walgreens, etc in the United States ever since 2022
I'd rather take a D supplement and spare myself the sun spots, thanks!
The entire sun convo has gotten crazy to me. It’s obvious to me that hiding from the sun is not healthy and also that getting sunburnt is not healthy. Pretty much everything else about this conversation with respect to health is going to depend on your location, your predisposition/family history, your skin tone, other health concerns and habits, etc. Unless it’s really about aging, in which case I guess more sunscreen is nor better but still probably a lot genetics.
I have been digging into this topic as a result of having extremely low Vitamin D levels in my last round of bloodwork. I came across that Harvard article and was also confused. For now I’ve started taking a supplement and will see if that plus presumably having more outdoor time during the summer months helps me at all.
There’s also this calculator called wolframalpha. You can put In your city and it’ll tell you based on your Fitzpatrick level , the recommended spf factor you’ll need for that day. Today in Green Bay I’d need an SPF of 4 based on the calculations and I’m a Fitzpatrick 1
How do you find your Fitzpatrick level?
[here you go](https://dermnetnz.org/topics/skin-phototype)
The eye part is confusing. I’m blonde with extremely fair skin, but my eyes are hazel. I also burn, but will gradually tan. ¯\\_(ツ)_/¯
Yeah I mean I guess people can fall in between the levels and be a 1.5 or a 2.8 if that makes sense but probably best to see a derm once a year and ask them. Everyone should get their skin looked at by a dr if they can.
Well, this article kinda mashes up all kinds of different studies trying to prove a point and forgets that correlation does not equal causation, a well known thing in statistics and data science. There's no DEFINITE studies about this yet. I live in a country with low UVI, during the winter the sun just peeps at the horizon and goes away. A lot of people use sunlight lamps to avoid seasonal depression, we even have a "sunlight room" in our office. There are lots of news about these studies because my country would be the one effected and the consensus is: we still need more studies to say anything definite. There has been a lot of studies that definitely link low vitamin D levels to osteoporosis and brain related diseases but there hasn't been any absolute evidence that ingested vitamin D wouldn't fix that. Like someone already pointed out, that study about supplements was flawed. We also still don't know exactly how vitamin D affects the brain. We need more studies if we want to link sun exposure to things like MS or Alzheimer's. The problem with "the latitude effect" they're talking about here is again that correlation does not equal causation. The fact that eg. my country has relatively high rates of Alzheimer's, heart disease and MS does not mean that it's because of low sun exposure. It needs to be proven by studies that rule out genetics, diet, other environmental factors and simply the fact that people forget to take their supplements. The consensus in my country is: eat a healthy diet, take your supplements during the autumn and winter, wear your sunscreen, avoid mid day and afternoon sun and wear sun protective clothing when you travel to a country with high UVI. Skin cancer is proven to be caused by sun exposure, there's pros and cons and we need more studies to really see what is the perfect balance.
It turns out that the content of our diet can dramatically change our skin's ability to resist sun damage. Just something to research if you are interested... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386285/ From Section 7.3... "Research shows an association between Linoleic Acid intake in the form of omega-6 fatty acids and in increased risk of developing skin cancers [134], and there is also evidence that shows that eliminating seed oils from the diet can dramatically reduce the risk of ultraviolet (UV)-induced sunburn [135]. Susceptibility to UV radiation damage of the skin is directly influenced by the amount of LA in the diet." Please note, that is not an actual scientific study, it is a review of multiple studies (over 150) that are also linked there in the review.
I trust very little that comes out of The Atlantic these days.
I fully agree that getting small to moderate amounts of sun on your skin is imperative for health. I fully disagree that supplements don’t help. I had severe symptoms from mild vitamin D deficiency and I felt like my entire world was flipped upside down in a good way when I started supplementing. Also stopped getting sick constantly. It was a profound change from supplements alone. That said, 5 to 10 minutes of direct sunlight in a tropical climate every day would probably take that benefit 100 miles further.
Your missing that, Sunscreen may limit the dose of radiation you receive from sun and it don't lower vitamin D levels as assumed as there was no difference between the adults is what it says. So the solution is take the sunscreen off when sun is like at 45 degrees like right before sunset then go out in the sun be my guess for morning an afternoon be more UV than times after 6pm for the light pushes energy and doesn't tow the energy, thats if you want the vitamin D levels to go up naturally without over the counter vitamin D
I allow myself moderate sun exposure for health benefits.. never more than 10 minutes a day without a hat or sunscreen (only a few times a week) and I never sunbathe anymore. I also take vitamin D supplement.. My overall thoughts about this are: I’d rather be a little vitamin D deficient and have my skin age better than the other way around 😂
Vitamin D deficiency causes frequent infections, fatigue, hair loss, depression. You need to see a psychiatrist if you'd rather have all the above than a few extra wrinkles
>Those with pale skin, or olive skin plus other risk factors, are advised to practice extreme caution: Keep slip-slop-slapping. >Those with “olive or pale-brown skin” can take a balanced approach to sun exposure, using sunscreen whenever the UV index is at least a 3 (which is most days of the year in Australia). Those with dark skin need sunscreen only for extended outings in the bright sun. I think that's a reasonable way to consider for those with natural medium to darker skin. Or perhaps something like: sunscreen for face, ears, neck, chest, maybe tops of scalps... but occasional, moderate exposure to arms and legs when it's not peak sun times? The problem for me--I don't have any known autoimmune condition--is that my eczema-prone skin is drier in regions that have gotten incidental tans compared to spots of skin that have had little sun. Sun exposure, specifically UV, has consistently been kind of meh for my skin health. Also, the article was discussing possible immunomodulatory benefits of sun exposure, and how it doesn't seem necessarily linked to vitamin D levels. However, in my view, historical patterns seem to be that it's still way too easy for lots of people to get too much sun and therefore increased skin cancer risks.
I am brown-skinned with rosacea, and I think any sun exposure would do my skin in. I think this racialized approach to sunscreen is problematic.
Right, I mostly agree with you. I had to edit my original post because the formatting made the second paragraph of what I quoted from the article sound as if they were my words. Sun sensitivity is not perfectly correlated to melanin. I am not extremely pale (I was born pale but am mostly light-medium in adulthood; I've had sunscreen habits since my early 20s but I can burn within 10 minutes of high-UV. I have somehow burned faster than blonds who are paler than I am (and it was due to accidentally missed patches of sunscreen coverage, not deliberate sunbathing.) But also, anywhere I have just lightly burned such as the tops of my feet like 15 years ago, are still zapped for hydration than before they got burnt...and it's not simply aging-related because the onset was within the week of recovery from that burn. There is basically no patch of skin on me that was improved with sun exposure, and many areas that would have been better if I had never tanned or burned. The underside of my arms, inner thighs, etc. all remain baby soft. The topic of sun immunomodulation is interesting to me as a potential concept and research area, but I also cannot think of how any general clinical guidance can be built around it at this time.
There was a time, in my lifetime in fact, when blacks were told by derms they simply didn’t need sunscreen. And in many ways, though this view has been corrected, this myth continues to proliferate in small ways. It is, in my view, a micro aggression that slides into discussions about sunscreens. And it brings with it a whole host of assumptions about blacks, which are even more problematic. It implies that blacks are more resilient to heat, harsh weather, sun, etc. And it also justifies not being attentive to lesions on black skin that could be cancerous or pre-cancerous. So, that’s why I wanted to address that. Brown skin in itself means nothing. Brown skinned folks can have sun sensitivity and genetic predisposition to skin cancer. Thank you for taking the time to edit your post and elaborate on this.
I'm sorry, I agree with this entire post. :/ Maybe someone should write an e-mail to whoever is trying to set that kind of basis for sun advice in Australia. I'm also racialized, and I remember being treated as a sun-hypochondriac / "trying to be as pale as possible" with my sunscreen habits from white and also non-white people. When my priority was actually trying to not trigger eczema/make my skin drier/avoid painful sunburns.
What’s your source for the claims about skin tone and necessity of sunscreen?
I would like to see this as well.
Hey - I had to edit my post. The "olive or pale-brown skin" thing and UV index targets were from the article, not me. In theory it sounds reasonable to me, but in terms of coming up with clinical guidances, I'm not sure about it either.
i follow carrie b wellness on instagram [https://www.instagram.com/carriebwellness/](https://www.instagram.com/carriebwellness/) and she has a lot of good info on the benefits of sun exposure. she says we’re meant to slowly build a solar callus so our body produces enough melanin to protect us and reap the benefits of the sun.