Insufficient Vitamin D is Serious

Sometimes called the “sunshine vitamin” because it is made in our skin upon exposure to sunlight, most Americans and many people worldwide suffer from insufficient amounts of vitamin D, especially in the winter. Insufficient vitamin D is a serious concern. John Jacob Cannell, MD, the founder of the non-profit Vitamin D Council explains, "Current research indicates vitamin D deficiency plays a role in causing seventeen varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects and periodontal disease." So, yes, nearly ALL our biggest chronic diseases and health conditions are at least partly caused by or worsened by insufficient vitamin D.

Vitamin D and skin picking

Some vitamin D sensitive conditions specifically concern those with chronic skin picking behaviors:

vitamin D and depression

Depression is one condition that can impact skin picking and make it difficult to recover. A positive attitude and energy to implement new habits are needed to combat the picking. If you experience depression, especially seasonally, you must pay attention to your vitamin D, and supplement as needed.

Vitamin D and Skin Conditions

Many people find their skin picking is partially caused by other skin conditions, which improve with exposure to sunlight or vitamin D. Acne often decreases with exposure to the sun, and that may be because Vitamin D also helps fight bacteria that cause acne.

Skin disorders like psoriasis and eczema also improve with vitamin D creams or UV light therapy.

Many skin pickers have keratosis pilaris (KP), tiny bumps most commonly on the backs of the upper arms, which also may improve from vitamin D. As “Lagne” from a CNN blog on keratosis pilaris says, “I've been a lifelong KP sufferer. I've tried it all – scrubbing, not scrubbing, chemical/manual exfoliators, AHA moisturizers, evvvverything.  When I moved to Florida and started spending lots of time in the sun, my KP completely disappeared. It actually made me laugh – years of effort and hundreds of dollars, and all I had to do was get out in the sun. I usually spend a few hours in the sun with a little sunscreen; the benefits last about two months before I feel the bumps start to reoccur.”

Sun, diet and skin cancer

Wait, but doesn't sun exposure cause skin cancer? The story may not be that simple. Sun exposure increases free-radicals in the skin, which can mutate DNA and cause skin cancers, but antioxidants from fruits and vegetables (and in our skincare) can deactivate free-radicals. Research is starting to confirm that your diet can help prevent skin cancer, that loading up on vegetables of all colors, drinking tea and using skincare ingredients like topical vitamin C and green tea extract can prevent or reverse cancer-causing sun damage in the skin. So, it may not be sun that causes skin cancer, but rather sun while eating an insufficiently nutritive diet.

Also consider that all those diseases listed in the first paragraph of this post cause much more suffering and mortality, for so many more people, than do skin cancers.

Here's a paragraph from an article explaining why the World Health Organization (WHO) is more concerned about the impact of low exposure to UV radiation rather than high exposure:

"However, excessive UVR exposure accounts for only 0.1% of the total global burden of disease in disability-adjusted life years (DALYs), according to the 2006 World Health Organization (WHO) report The Global Burden of Disease Due to Ultraviolet Radiation. DALYs measure how much a person’s expectancy of healthy life is reduced by premature death or disability caused by disease. Coauthor Robyn Lucas, an epidemiologist at the National Centre for Epidemiology and Population Health in Canberra, Australia, explains that many diseases linked to excessive UVR exposure tend to be relatively benign—apart from malignant melanoma—and occur in older age groups, due mainly to the long lag between exposure and manifestation, the requirement of cumulative exposures, or both. Therefore, when measuring by DALYs, these diseases incur a relatively low disease burden despite their high prevalence.

In contrast, the same WHO report noted that a markedly larger annual disease burden of 3.3 billion DALYs worldwide might result from very low levels of UVR exposure. This burden subsumes major disorders of the musculoskeletal system and possibly an increased risk of various autoimmune diseases and life-threatening cancers."

How to know if you have insufficient vitamin D

So, how do you know whether you are deficient in vitamin D?

1) A very low-tech test is to press your fingertips firmly into your sternum (breastbone). If it hurts, you are probably extremely low in vitamin D.

2) A blood test for vitamin D3, so it is a good idea to ask your doctor for it. In most states in the US, you can actually order one yourself via directlabs.com and go to a Quest Diagnostics location for a blood draw. Experts disagree on a vitamin D blood level that's ideal, but somewhere between 50-100 ng/ml (check you're comparing same units!) is probably a good range. If lower than that, you may want to consider either more sun or supplementation.

Vitamin D from Food, sun, and supplements

It is nearly impossible to get sufficient vitamin D from our food. Milk is typically supplemented with vitamin D2, less beneficial than vitamin D3, and in the amount that only prevents rickets, the acute vitamin D deficiency disease, not enough for the cancer protection and other benefits. Plus milk and other dairy can increase acne.

Moderate sun exposure in the summer, 10 to 15 minutes midday (without sunscreen) is generally a good amount if it's not enough to turn you pink. However, most of us live at too high a latitude to get any significant amount of sun in the winter, so supplementing is most likely necessary for a few months at least (especially if you tend to experience seasonal depression).

Some of us, myself included, have genetics that make it very hard to raise our vitamin D levels to the optimum levels for health. I have to supplement a lot. 2000 IU, a typical amount in a multivitamin, has never been enough for me - I need 5000-10000 IU per day.

Cod liver oil is one good way of supplementing vitamin D, along with the essential fatty acids you might be getting from a fish oil capsule. Supplementing with a food based source like cod liver oil is beneficial because it contains a balance of fat-soluble nutrients, reducing the likelihood of overdosing on any one. A fermented cod liver oil specifically is stable and won't go rancid. If you don't like the taste you can try it in capsules. Or take specific vitamin D3 supplements. Liquid or capsule form is best. You will want to take it with food containing fat for best absorption. Since D is a fat-soluble vitamin, it is possible to take too much of it, yet it is unlikely when supplementing with D3 rather than D2. When in doubt, follow the instructions on the bottle and get your blood tested periodically to be sure your D level is in the safe range.

Read this post next to learn more about food and skin picking.

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