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Medical Forum / Diseases and Disorders / Prostate Cancer / October 2006

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October 2006 follow up: "Is melanoma simply a Vitamin D deficiency cancer?"

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James Semmel - 10 Oct 2006 16:29 GMT
TO: All melanoma researchers, doctors, and patients.

Doesn't anyone else find it curious that, of all the cancers being
touted by researchers as Vitamin D deficiencies, melanoma is not one of
them?

James Semmel
Albuquerque, New Mexico

reference:
http://www.mpip.org/bb/shtml/351407.shtml
Last month's follow up to the 3rd annual discussion: "Is melanoma
simply a Vitamin D deficiency cancer?"
Alan Meyer - 10 Oct 2006 20:21 GMT
> TO: All melanoma researchers, doctors, and patients.
>
> Doesn't anyone else find it curious that, of all the cancers being
> touted by researchers as Vitamin D deficiencies, melanoma is not one of
> them?

James,

I remember your posting about this a month ago.  I
found it intriguing but, knowing very little about melanoma,
I wasn't able to contribute anything, and still can't.

Isn't anyone researching this?  It does, on the
surface of it, seem like Vitamin D and melanoma
could be related since both have to do with exposure
to the sun.  However I recall the posting you made was
the exact opposite of received wisdom - which is that
_too much_ exposure to the sun is a cause of
melanoma, not too little.

Have you made any progress in researching this?

   Alan
James Semmel - 10 Oct 2006 23:29 GMT
Hi Alan,

Good to hear from you again!  (Did you ever read some of Dr. Rossi's
publications about shoes and their effect on posture?  I recall we were
in a discussion about how shoes cause Alzheimer's disease.)

That's right, too much sun exposure could cause melanoma via the
resultant deficiency in Vitamin D.  Bear in mind that the body's
protective mechanism called tanning inhibits the synthesis of Vitamin D
in the skin to prevent toxicity.

In other words, the prevention of melanoma is an optimization problem
involving sun exposure.  Doctors and researchers from the last
quarter-century, however, advised minimizing sun exposure, dubious and
deadly advice.

james

> > TO: All melanoma researchers, doctors, and patients.
> >
[quoted text clipped - 19 lines]
>
>     Alan
Alan Meyer - 10 Oct 2006 23:33 GMT
> Hi Alan,
>
> Good to hear from you again!  (Did you ever read some of Dr. Rossi's
> publications about shoes and their effect on posture?  I recall we were
> in a discussion about how shoes cause Alzheimer's disease.)

Ah yes.  I had forgotten.  You are the shoe guy.

I'm afraid I'm not qualified to comment on the vitamin D
theory.

Good luck to you though.

   Alan
James Semmel - 11 Oct 2006 16:11 GMT
Thanks  Alan!

james

> > Hi Alan,
> >
[quoted text clipped - 10 lines]
>
>     Alan
Matti Narkia - 11 Oct 2006 16:43 GMT
>> TO: All melanoma researchers, doctors, and patients.
>>
[quoted text clipped - 15 lines]
>_too much_ exposure to the sun is a cause of
>melanoma, not too little.

About 20 minutes full body exposure to the sun's UVB radiation on a
sunny summer day causes the synthesis of 10 000 - 25 000 IU of vitamin
D3 in the skin of light skinned people. Dark skinned people need 120
minutes to produce the same amount of vitamin D3. After that the
sunlight starts destroying the already formed vitamin D3 in the skin
at the same rate than new vitamin D3 is being formed. So for light
skinned people there is no reason stay in the sun longer than 20
minutes (120 minutes for dark skinned people) to get the maximum daily
dose of vitamin D3. Staying in the sun 10-20 minutes on sufficient
number of sunny summer days will guarantee more than adequate supply
of vitamin D. Anything longer that 20 minutes is not necessary, and
could be harmful.

Signature

Matti Narkia

JohnHace - 11 Oct 2006 20:45 GMT
> About 20 minutes full body exposure to the sun's UVB radiation on a
> sunny summer day causes the synthesis of 10 000 - 25 000 IU of vitamin
[quoted text clipped - 8 lines]
> of vitamin D. Anything longer that 20 minutes is not necessary, and
> could be harmful.

There seem to be many variables unaddressed here. Variations in "light"
skin, "full body" exposure, sunny or partly cloudy, morning or mid-day
or afternoon, spring or summer or fall and last but not least,
latitude.

Also, what would a "sufficient number of sunny summer days" be? And
does the adequate supply then last through the fall, winter and spring?

Thanks,

John
Matti Narkia - 12 Oct 2006 01:31 GMT
>> About 20 minutes full body exposure to the sun's UVB radiation on a
>> sunny summer day causes the synthesis of 10 000 - 25 000 IU of vitamin
[quoted text clipped - 11 lines]
>There seem to be many variables unaddressed here. Variations in "light"
>skin,

The range for the time required for maximun daily vitamin D dose is
20-120 minutes for the lightest (white) skin to the darkest (black)
skin. Intermediate skin colors are somewhere within this time range. A
simplistic approach to estimate the time needed by a person to get
his/her maximum daily dose of vitamin D would be to assess where
his/her skin fits in the range white - black using some numerical
value, say between 0 (white) and 1 (black), and use that number to
interpolate between 20 and 120 minutes. This will of course give only
a very rough estimate, but frankly currently I'm not aware of any more
accurate method.

>"full body" exposure,

Naked. I thought that that would be obvious. Close enough
approximation is not too big swimming suit.

>sunny or partly cloudy,

I did write "sunny summer day". You get some reduced UVB-radiation
even on partly cloudy summer day, but the maximum dose may be
decreased or/and time needed for it may be lengthened.

>morning or mid-day or afternoon,

Midday for the maximum dose, although a reduced dose may be obtained
in the morning and afternoon.

>spring or summer or fall and last but not least, latitude.

Summer is the best. Outside 40th latitudes far in the north and south
there is not enough UVB-radiation in the winter to promote cutaneous
synthesis of vitamin D. The length of this "vitamin D winter" depends
on the latitude. In tropics you naturally get sufficient UVB-radiation
throughout the year. See the studies by Webb et al. and Engelsen et al
in the references later in this message

>Also, what would a "sufficient number of sunny summer days" be?

It has been estimated that the bodies of healthy men use 3000 - 5000
IU of vitamin D/d, if it is available. So to retain the vitamin D
status (serum 25(OH)D concentration), one needs in average get that
amount per day from whatever sources. Food is almost neglible source
of vitamin D (fish is the best) and you cannot get 3000 - 5000/d from
food. You can approximate the sufficient number of days, when you know
that the maximum dose from exposure to the sun is 10 000 - 25 000 IU/d
(you can use 10 000 in calculations), and that you need to get in
average about 3000 - 5000 IU/d (say 4000 IU/d). Rough estimate is that
you would need to get the maximum dose (20 minutes full body exposure,
if you are white) every 2.5 days in the midday in a sunny summer day
or more often, if you cannot do it in midday, time is shorter or you
don't get full body exposure. This is for optimal vitamin D levels.
Many people get less and are doing ok, but risk of some chronic
diseases may increase if the average daily dose is much too low. And
old people synthetize vitamin D in the skin much less effectively than
young people, they may produce only 25% of the amount younger people
can produce. Therefore older people may need supplements throughout
the year.

>And does the adequate supply then last through the fall, winter and spring?

It depends on the latitude. In tropical areas cutaneous synthesis of
vitamin D is possible throughout the year, but in far north and south
there is no cutaneous synthesis during "vitamin D winter", whose
length depends on the latitude. IMHO, in these areas it's sensible to
supplement with art least 2000 IU/d during "vitamin D winter" to
prevent vitamin D level falling too much in the winter (some vitamin D
researcers thinj that big seasonal fluctuations in vitamin D level
could be harmful). Again I would recommend that you browse through the
studies by Webb et al. and Engelsen et al in the references later in
this message

You may find following references useful:

Vieth R.
Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and
safety.
Am J Clin Nutr. 1999 May;69(5):842-56. Review.
PMID: 10232622 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/69/5/842>

Vieth R, Chan PC, MacFarlane GD.
Efficacy and safety of vitamin D3 intake exceeding the lowest observed
adverse effect level.
Am J Clin Nutr. 2001 Feb;73(2):288-94.
PMID: 11157326 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/73/2/288>

Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ.
Human serum 25-hydroxycholecalciferol response to extended oral dosing
with cholecalciferol.
Am J Clin Nutr. 2003 Jan;77(1):204-10. Erratum in: Am J Clin Nutr.
2003 Nov;78(5):1047.
PMID: 12499343 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/77/1/204>
<http://www.ajcn.org/cgi/content/full/78/5/1047> (Erratum)

Webb AR, Kline L, Holick MF.
Influence of season and latitude on the cutaneous synthesis of vitamin
D3: exposure to winter sunlight in Boston and Edmonton will not
promote vitamin D3 synthesis in human skin.
J Clin Endocrinol Metab. 1988 Aug;67(2):373-8.
PMID: 2839537 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R
etrieve&dopt=abstractplus&list_uids=2839537
>

Engelsen O, Brustad M, Aksnes L, Lund E.
Daily duration of vitamin D synthesis in human skin with relation to
latitude, total ozone, altitude, ground cover, aerosols and cloud
thickness.
Photochem Photobiol. 2005 Nov-Dec;81(6):1287-90.
PMID: 16354110 [PubMed - indexed for MEDLINE]
<http://www.bioone.org/perlserv/?request=get-abstract&issn=0031-8655&volume=81&pa
ge=1287
>

Check out also the pages

VitD Duration of Vitamin D Synthesis in Human Skin
<http://zardoz.nilu.no/~olaeng/fastrt/VitD.html>

VitD-ez Easy Duration of Vitamin D Synthesis in Human Skin
<http://zardoz.nilu.no/~olaeng/fastrt/VitD-ez.html>

mentioned in the above abstract.

References about vitamin D and cancer:

Holick MF.
Vitamin D: its role in cancer prevention and treatment.
Prog Biophys Mol Biol. 2006 Sep;92(1):49-59. Epub 2006 Mar 10. Review.
PMID: 16566961 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16566961
>

Gombart AF, Luong QT, Koeffler HP.
Vitamin D compounds: activity against microbes and cancer.
Anticancer Res. 2006 Jul-Aug;26(4A):2531-42. Review.
PMID: 16886661 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16886661
>

Spina CS, Tangpricha V, Uskokovic M, Adorinic L, Maehr H, Holick MF.
Vitamin D and cancer.
Anticancer Res. 2006 Jul-Aug;26(4A):2515-24. Review.
PMID: 16886659 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16886659
>

Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB,
Holick MF.
The role of vitamin D in cancer prevention.
Am J Public Health. 2006 Feb;96(2):252-61. Epub 2005 Dec 27. Review.
PMID: 16380576 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16380576
>

Giovannucci E.
The epidemiology of vitamin D and cancer incidence and mortality: a
review (United States).
Cancer Causes Control. 2005 Mar;16(2):83-95. Review.
PMID: 15868450 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=15868450
>

Holick MF.
Vitamin D: importance in the prevention of cancers, type 1 diabetes,
heart disease, and osteoporosis.
Am J Clin Nutr. 2004 Mar;79(3):362-71. Review. Erratum in: Am J Clin
Nutr. 2004 May;79(5):890.
PMID: 14985208 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/79/3/362>

Signature

Matti Narkia

Matti Narkia - 12 Oct 2006 13:01 GMT
>>> About 20 minutes full body exposure to the sun's UVB radiation on a
>>> sunny summer day causes the synthesis of 10 000 - 25 000 IU of vitamin
[quoted text clipped - 133 lines]
>
>mentioned in the above abstract.

Some additional references:

Matsuoka LY, Wortsman J, Haddad JG, Hollis BW.
In vivo threshold for cutaneous synthesis of vitamin D3.
J Lab Clin Med. 1989 Sep;114(3):301-5.
PMID: 2549141 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=2549141
>

Webb AR.
Who, what, where and when-influences on cutaneous vitamin D synthesis.
Prog Biophys Mol Biol. 2006 Sep;92(1):17-25. Review.
PMID: 16766240 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R
etrieve&dopt=abstractplus&list_uids=16766240
>

Lucas RM, Ponsonby AL.
Ultraviolet radiation and health: friend and foe.
Med J Aust. 2002 Dec 2-16;177(11-12):594-8.
PMID: 12463975 [PubMed - indexed for MEDLINE]
<http://www.mja.com.au/public/issues/177_11_021202/luc10478_fm.html>

Signature

Matti Narkia

JohnHace - 12 Oct 2006 16:45 GMT
> >"full body" exposure,
>
[quoted text clipped - 11 lines]
> Midday for the maximum dose, although a reduced dose may be obtained
> in the morning and afternoon.

Matti,

Thanks for that explanation.

I have a couple more questions. It seems like I remember reading years
ago that, for maximum D, one should not bath immediately before or
after exposure. It seemed to have something to do with oil on the skin.
They said this oil needed to be re-absorbed into the skin after
exposure for the body to get the maximum effect. I have not seen this
anywhere since. Is this valid?

Also, what is your opinion regarding tanning beds? At least there is no
variation from day to day and season to season.

Thanks,

John
Matti Narkia - 13 Oct 2006 00:22 GMT
>> >"full body" exposure,
>>
[quoted text clipped - 22 lines]
>exposure for the body to get the maximum effect. I have not seen this
>anywhere since. Is this valid?

I've heard the same story, but I don't know if it is true. I think
that the logic behind the story is that vitamin D is formed so near
the surface of the skin, that having a shower or bath could wash it
away before it can be absorbed and moved to the circulation. So it all
comes down to the question whether vitamin D formed so near the skin
surface that it could be washed away? I honestly don't know.

>Also, what is your opinion regarding tanning beds? At least there is no
>variation from day to day and season to season.

If with tanning beds you mean regular solariums, they are no use in
getting vitamin D, because they produce only or mostly UVA radiation,
and not UVB-radiation needed to promote cutaneous vitamin D synthesis.
But there are other kind of "sun beds", which are designed to promote
vitamin D synthesis in the skin, and they produce also UVB radiation.
They are not yet as common as regular solariums, and I don't know
about their safety. But if proven safe, the advantage would of course
be that you could get the same constant vitamin D production in the
skin throughout the year, as you mentioned. Still, why to bother, when
you can take supplements, which cause nor harm for the skin, whenever
you don't get enough vitamin D from the sun.

Signature

Matti Narkia

I.P. Freely - 12 Oct 2006 06:13 GMT
>  Anything longer that 20 minutes is not necessary, and
> could be harmful.

But isn't the production of D self-limiting? If not, I should be able to
 live in a cave for the next 30 years without any D problems -- and
donate enough D to take care of several Norwegian librarians --
considering the time I've spent in the desert, beach, and high altitude
sun.

I.P.
Matti Narkia - 12 Oct 2006 07:54 GMT
>>  Anything longer that 20 minutes is not necessary, and
>> could be harmful.
>
>But isn't the production of D self-limiting?

That's exactly what I wrote, if you bother to read my message. After
20 minutes in the sun as much vitamin D is destroyed in the skin by
sunlight as is produced by the stimulation by the sun's UVB-radiation.
Therefore for vitamin D production any longer stay in the sun than 20
minutes at the time is useless, waste of time and may harm the skin.

Signature

Matti Narkia

Matti Narkia - 12 Oct 2006 12:51 GMT
>>>  Anything longer that 20 minutes is not necessary, and
>>> could be harmful.
[quoted text clipped - 6 lines]
>Therefore for vitamin D production any longer stay in the sun than 20
>minutes at the time is useless, waste of time and may harm the skin.

More information about this in the articles

Webb AR, DeCosta BR, Holick MF.
Sunlight regulates the cutaneous production of vitamin D3 by causing
its photodegradation.
J Clin Endocrinol Metab. 1989 May;68(5):882-7.
PMID: 2541158 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=2541158
>

   "Exposure to sunlight initiates the formation of vitamin D3 in
   skin as the UV B radiation in the solar spectrum causes the
   photoconversion of 7-dehydrocholesterol to previtamin D3. A
   heat-induced isomerization then converts previtamin D3 to
   vitamin D3 over a period of days. A number of irradiation
   products of vitamin D3 are known to form upon irradiation with
   high intensity UV radiation, but the effect of subsequent
   exposures to sunlight on the vitamin D3 formed in skin is not
   known. To investigate this phenomenon, human skin containing
   vitamin D3 was exposed to sunlight in Boston. A model system of
   [3H]vitamin D3 in methanol was also used to study the effects
   of sunlight on vitamin D3 throughout the year. Vitamin D3
   proved to be exquisitely sensitive to sunlight, and once formed
   in the skin, exposure to sunlight resulted in its rapid
   photodegradation to a variety of photoproducts, including 5,6-
   transvitamin D3, suprasterol I, and suprasterol II."

and

Vieth R.
Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and
safety.
Am J Clin Nutr. 1999 May;69(5):842-56. Review.
PMID: 10232622 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/69/5/842>

   "At least 4 studies support the concept that one full-body
   exposure to sunlight can be equivalent to an oral vitamin D
   intake of 250 µg (10000 IU). Stamp (39) compared oral vitamin D
   to the effects of ultraviolet light treatment sessions and
   found that the rise in 25(OH)D was the same in subjects treated
   with ultraviolet light as in those given 250 µg (10000 IU)
   vitamin D/d. In a study of institutionalized elderly, Davie et
   al (28) exposed 600 cm2, {approx}5% of skin surface, to
   ultraviolet light treatments over a 2–3-mo period and compared
   the resulting 25(OH)D concentrations with those achieved with
   oral vitamin D doses. They calculated a production of vitamin D
   in the skin equivalent to 0.045 nmol •d-1•cm-2 exposed skin.
   This is equivalent to 10.9 µg (435 IU) vitamin D/d for 5% of
   skin surface. An almost identical protocol was followed
   recently by Chel et al (30), confirming the relative effects of
   light and supplementation on 25(OH)D concentration (28). If
   these results for the elderly are extrapolated to total body
   surface area, it works out to 218 µg (8700 IU) vitamin D/d that
   can be acquired by the elderly. More recently, Holick (40)
   presented data that compared blood vitamin D concentrations in
   subjects taking vitamin D orally with those given ultraviolet
   light exposure. The ultraviolet treatment produced blood
   vitamin D concentrations comparable with an intake of 250–625
   µg (10000–25000 IU) vitamin D/d orally.

   Ultraviolet exposure beyond the minimal erythemal dose does not
   increase vitamin D production further. The ultraviolet-induced
   production of vitamin D precursors is counterbalanced by
   degradation of vitamin D and its precursors. The concentration
   of previtamin D in the skin reaches an equilibrium in white
   skin within 20 min of ultraviolet exposure (41). Although it
   can take 3–6 times longer for pigmented skin to reach the
   equilibrium concentration of dermal previtamin D, skin
   pigmentation does not affect the amount of vitamin D that can
   be obtained through sunshine exposure (42). However, aging does
   lower the amount of 7-dehydrocholesterol in the skin and lowers
   substantially the capacity for vitamin D production (43, 44)."

Signature

Matti Narkia

I.P. Freely - 13 Oct 2006 01:14 GMT
>>>  Anything longer that 20 minutes is not necessary, and
>>> could be harmful.

>> But isn't the production of D self-limiting?
>
> That's exactly what I wrote, if you bother to read my message.

I "bothered", Matti, but interpreted your comment differently than you
intended.

> After
> 20 minutes in the sun as much vitamin D is destroyed in the skin by
> sunlight as is produced by the stimulation by the sun's UVB-radiation.
> Therefore for vitamin D production any longer stay in the sun than 20
> minutes at the time is useless, waste of time and may harm the skin.

Because you answered "Does the adequate supply then last through the
fall, winter and spring?" with "It depends on the latitude" and since
ANY sun "harms the skin", I presumed you meant longer exposure would
overdo the D in the long haul. Thanks for correcting my misinterpretation.

I.P.
Matti Narkia - 13 Oct 2006 02:28 GMT
>>>>  Anything longer that 20 minutes is not necessary, and
>>>> could be harmful.
[quoted text clipped - 5 lines]
>I "bothered", Matti, but interpreted your comment differently than you
>intended.

Ok, no problem. Perhaps I should have expressed myself more clearly.

>> After
>> 20 minutes in the sun as much vitamin D is destroyed in the skin by
[quoted text clipped - 6 lines]
>ANY sun "harms the skin", I presumed you meant longer exposure would
>overdo the D in the long haul. Thanks for correcting my misinterpretation.

Thanks for staying interested.

Signature

Matti Narkia

I.P. Freely - 13 Oct 2006 04:15 GMT
> Thanks for staying interested.

It's pretty easy, given D's critical role in many bodily systems,
functions, and maladies. I've been watching it for many years, having
lived many places from Florida to near Canada.

I.P.
 
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