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North Carolina doctor’s vitmain D recommendations questioned

Monday, May 25th, 2009

A North Carolina physician’s vitamin D recommendations published in The Greensboro News-Record have been questioned by the International Smart Tan Network as an example of how little clinical physicians actually know about vitamin D.

2009-05-22-fuzzy-math-tanningnews-copy.jpgDr. Candace Smith, from Eagle Physicians and Associates in North Carolina, wrote a question-and-answer piece in the News Record suggesting that 15 minutes a week of sun exposure is all you need to make vitamin D.

“You should not stop using sunscreen due to the risk of skin cancer but you can go outside for 15 minutes per week without sunscreen, but make sure you limit it to this amount. Limited sun exposure with oral supplements is the best preventive measure, especially since so many people have turned away from milk products,” Smith wrote.

Here’s what’s wrong with her statement:

1) 15 minutes a week of sun exposure — even at noon in the summer on a sunny day — would only produce about 400 IU of vitamin D for a fair-skinned person exposing their face and arms to the sun without sunscreen. Since she is suggesting people do that just once a week, that’s 35 times less than what vitamin D experts say we now need just to maintain healthy vitamin D levels (2000 IU/daily: www.grassrootsHealth.org). For a dark-skinned person, who needs up to 10 times more UV to make the same amount of vitamin D, her recommendation may only add up to 40 IU of vitamin D per week.

“Smith is probably parroting something she’s been told, but that figure is baseless, without any scientific merit and is potentially dangerous,” Smart Tan Vice President Joseph Levy said.

2) Sunscreen prevents sunburn, but sunscreen manufacturers themselves are not permitted to advertise that their product prevents skin cancer since no data suggests this is the case. More studies show that sunscreen users have higher melanoma rates than lower rates — a finding that is unexplained but contradicts any suggestion that sunscreen prevents cancer.

Smart Tan supports the usage of sunscreen only in occasions when sunburn is a possibility. Daily sunscreen usage has contributed to epidemic levels of vitamin D deficiency.

To read the Greensboro News-Record story click here.

Vitamin D Q&A

Candace Smith, M.D. at Eagle Physicians and Associates answered some common questions about vitamin D:

Q: How do you know you have a deficiency?

A: Most people do not have symptoms of vitamin D deficiency. Occasionally, I find that my patients with nonspecific muscle/joint pain will have vitamin D deficiency that improves with replacement of the vitamin. It is determined by a blood test.

Q: Who should be tested?

A: The people with the highest risk of vitamin D deficiency will be the elderly (due to decreased ability for the skin to make vitamin D from sunlight and with their decreased exposure to sunlight and decreased absorption in the GI tract) and anyone who has had gastric bypass or malabsorption syndromes including Celiac disease. Healthy adults are at risk during the wintertime (recommend increasing oral vitamin D during this time of year.) Children who don’t take in sufficient amounts of vitamin D, found especially in milk fortified products or cereals, are at risk. Anyone who has been diagnosed with osteopenia or osteoporosis and anyone with chronic kidney or liver disease should have their vitamin D level checked.

Q: How much do you need? Can you take too much?

A: This would depend on your vitamin D level. Recommended amounts for adults would be 800-1,000 IU of vitamin D daily and you can get this over the counter. It should be vitamin D3. If you have a deficiency (lab value less than 20 ng/ml) then you would definitely need a prescription dose of 50,000 IU taken once a week for 8-12 weeks then recheck your level. Overdose is rare but possible and lab values greater than 88 ng/ml are considered too much.

Q: Should you stop using sunscreen?

A: No, you should not stop using sunscreen due to the risk of skin cancer but you can go outside for 15 minutes per week without sunscreen, but make sure you limit it to this amount. Limited sun exposure with oral supplements is the best preventive measure, especially since so many people have turned away from milk products.

Source: New York-Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College; Milk Processor Education Program; American Medical Association (AMA)

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