Before winter arrives “expose yourself!!”

“Every winter I seem to catch colds and ‘flu continually.”… “My muscles and joints always seem to ache; I’m tired and my hair is falling out…”… “I’m now mid-life and the illnesses of old age loom large and concern me – how can I avoid the ravages of Parkinson’s Disease, Multiple Sclerosis, Alzheimer’s or brittle bones?”

These seemingly disparate complaints all have a common theme – they are ALL associated with Vitamin D deficiency in humans. Endemic diseases such as diabetes, high blood pressure, ‘stroke’, heart disease, thyroid dysfunction, depression, gum disease, seasonal influenza – as well as certain forms of cancer, multiple sclerosis, tuberculosis, autism in children from Vitamin D – deficient Mothers, or body muscle mass wasting also share this link.

The potential to develop autoimmune conditions such as alopecia areata, Vitilligo, psoriasis, & inflammatory bowel disease is believed to increase with Vitamin D deficiency. The risk of skin cancer is – paradoxically – decreased with adequate levels of Vitamin D.

“But don’t we get Vitamin D from the sun?” “How could this be a problem in a land of year-round sunshine and golden beaches?”

The controversial answer appears to be this: as a nation we’ve never quite understood ‘sensible exposure’ to sunlight. Previous generations of sun seekers literally tanned their skins into brown leather – or gave themselves 2nd degree burns in the endeavor. Sun-screen protection was rarely considered – nor was there any serious appreciation to the dangers of extreme UV index hours within the day. A tragic consequence to this obsession was Australia claims the highest rate of melanoma in the world.

After almost three successful (and necessary) decades of ‘Slip, Slop, Slap awareness, the pendulum has arguably swung too far the other way. Health screenings for nursing home residents across Australia found extensive Vitamin D depletion. Many people now – particularly women – take extraordinary precautions to avoid the sun. Four out of five patients routinely tested show decreased Vitamin D levels ranging from ‘insufficient’ to ‘severely deficient’.

So what is Vitamin D?

Vitamin D (as Cholecalciferol) is synthesised from sunlight when our bare skin is exposed to it. In a further conversion cascade involving enzymes from the liver & kidneys, the active & most potent form of Vitamin D – termed Calcitriol – is produced & stored in the liver & to a lesser extent, the tissues of the body.

Although commonly referred to as a ‘vitamin’, Calcitriol is a biological response-modifying steroid hormone – considered the most potent steroid hormone in the body.

Vitamin D is essential for the active absorption of Calcium & Phosphorus from the gut; regulating their utilisation within the body. Vitamin D is also integral to the production & balance of cells that constantly remodel our bones, the conversion of inactive thyroid hormone to the active form which influences every body cell, and aids in preventing Calcium and some other minerals from being excreted via the kidneys.

How much do we need?

An adult requires around 4,000 International Units (IU) i.e. 100 micrograms of Vitamin D per day. Approximately 15-30 minutes of strong sunlight on bare, non-sun screened skin – avoiding the hottest part of the day – will produce approximately 20,000 IU of Vitamin D, and provide a ready reserve of stores.

Melanin is conjugated in the skin to protect us against UV light. When a level of 20,000 IU of Vitamin D is achieved, melanin combines with ultra-violet light to (co-incidentally but purposely) limit Vitamin D production; corrupting excess Cholecalciferol so it cannot be further converted. According to Vieth (1999) there has never been a substantiated case of Vitamin D toxicity from sun exposure alone.

What food sources provide Vitamin D?

Dietary sources of Vitamin D are egg yolk; ‘oily’ fish such as salmon & sardines, cod liver oil – or EPA/DHA nutritional supplements, Vitamin D fortified bread & cereals, or milk. Be mindful though a standard glass of milk will provide about 100 IU of Vitamin D only – so you’d need to drink 40 glasses of milk per day to achieve 4,000 IU!

In Australia sensible sunlight exposure remains the most efficient & effective means to maintain optimal Vitamin D levels.

Who’s most at risk to be Vitamin D deficient?
  • All those who because of old age, frailty, infirmity or disability are predominantly confined to the indoors.
  • People who for religious or cultural reasons completely cover themselves whenever in public.
  • Darker skinned people such as full-blood Aborigines, Pacific Islanders, some Middle-Eastern or African immigrants. These groups may require 5-10 times longer exposure to synthesise the same amounts of Vitamin D that a fair skinned person would produce in 10-30 minutes. Because of their skin’s deeper pigment, many younger people and women within these groups tend to avoid exposing their bare skin to the sun.
  • Skin & Health problems:
    • Severe, systemic eczema/psoriasis or other skin disorder.
    • Liver disease may inhibit the conversion of Vitamin D to its active form.
    • Malabsorption due to its many causes can prevent dietary Vitamin D uptake and utilisation.
    • ‘Lactose intolerant’ people cannot properly digest milk, so they will not absorb the Vitamin D it contains.
  • Those who take Phenytoin Sodium (Dilantin) in long-term anti-convulsant therapy may acquire a ‘medication-induced’ Vitamin D deficiency due to this drug.
  • Vegetarians often have difficulty raising their Vitamin D levels through oral supplementation as the fatty acid content of meals is required to facilitate absorption. Daily sunlight exposure of 15-30 minutes is the better option (avoiding the hottest period of the day), or Vitamin D injections may be considered.

Assessing Vitamin D levels is achieved via blood pathology for 25-OH Vitamin D. The standard reference range is 51-200 nmol/L – levels less than 50-80 nmol/L may be associated with Vitamin D deficiency according to published guidelines, whilst the ‘target’ level is 125-150nmol/L.

A 2009 study found women with Vitamin D levels greater than 85nmol/L had a 50% LOWER RISK of being diagnosed with breast cancer than those women with levels less than 60nmol/L (Rejnmark: 2009).

Progressive medical doctors & researchers* speculate that annual testing and maintaining a woman’s Vitamin D and Iodine at their respective ‘optimal’ levels, the rate of breast disease/malignancy could be decreased by as much as 25%..! They also propose the body requires less demand for Thyroid and Cortisol hormone when Iodine + Vitamin D levels are optimised – allowing the body to operate more efficiently.

At the time of writing the present Federal Government has disallowed the Medicare bulk-billing of Vitamin D, Iodine, B12 and Folate testing; this now must be done at the Patient’s own expense. Treating a Woman who has diagnosed breast cancer can cost the taxpayer tens to hundreds of thousands $$$ – testing a Woman’s Vitamin D and Iodine levels cost the Government less than $100!!

Vitamin D deficiency has an adverse effect on hair growth due to its influence on thyroid-adrenal function. There are Vitamin D receptors in the scalp; Vitamin D is essential for hair follicle maturation (maturity). To positively influence any thyroid hormone conversion issues; autoimmune issues or help stabilise blood sugar levels Vitamin D must be maintained at 120-150nmol/L.

A Vitamin D deficiency can also trigger an autoimmune reaction in pre-disposed people as deficiency disorientates the immune system; attacking susceptible tissues such as the skin + the thyroid gland.

Readers who take thyroid medication are strongly advised to acquaint themselves with the latest (unpublished) study summary on Vitamin D daily dosage at my Blog. (www.hairlossclinic.com.au ). Supplementing Vitamin D when taking thyroid medication must be strictly monitored to prevent adverse interference of thyroid function by Vitamin D; the supplementing of Vitamin D in those taking prescribed thyroid medication is “less flexible” (Van Zanden: 2014)

Vitamin D supplementation should be prescribed by a Health Practitioner after
Vitamin D blood levels are established. Vitamin D3 – known as Cholecalciferol – is the only form of Vitamin D supplement that should be taken, as it’s the one naturally-occurring form for our bodies. All other forms of Vitamin D are metabolic or chemical alterations. Advocated supplementation is 3000-5000 units daily – as Vitamin D3 drops – taken with the evening protein** meal.

*Dr. John Cannell – Vitamin D Society (USA), Dr. Philip Van Zanden (UNSW), Drs. John Lee, Peter Lewis, Peter Baratosy et al.
** Vitamin D (as Cholecalciferol) is carried into the body on fatty acid proteins

A qualified Trichologist has studied & successfully completed a recognised Academic Trichology Educational Program. References are in the body of this + other related articles: www.hairlossclinic.conm.au