Heliophobe Madness

My last blog post reviewed a book by Dr. Michael Holick, one of the world’s experts on vitamin D, who recommends sensible sun exposure to experience the benefits of adequate vitamin D.  In that post I touched on the idiotic extremes the dermatology mainstream have adopted to discourage people from spending time in the sun.

It’s worse than I thought.

Not long after posting, I came across a McClatchy column in our local paper pushing the perspective of most dermatologists, a perspective that’s so unbelievable that it almost reaches comedic proportions. (Our local paper requires paid registration, so I’ve linked here to a paper that doesn’t.) The piece serves to show in spades the way dermatologists think (if that’s what you call it), and lets us know why their advice should be taken with a huge grain of salt.

The piece was written by a health writer, but her go-to experts were a couple of academic dermatologists:

We’ve got the skin-care basics from two experts in the field: doctors Nancy Thomas, associate professor at the University of North Carolina’s Department of Dermatology Lineberger Comprehensive Cancer Center, and Kelly Nelson, assistant professor at Duke University Medical Center’s Department of Dermatology.

As I started reading this article I was preparing myself for all the normal admonitions to slather with sunscreen, wear a big hat, avoid sun bathing, etc., but even I – who am used to reading idiocy in the press about things medical – was stunned at the levels of caution recommended by these brain-dead dermatologists.

Both of these doctors agree that everyone needs sun protection, and needs it apparently all the time. If you listened to them, you almost wouldn’t walk by an open window without using sunscreen first.

Even if you’re inside much of the day, you’re exposed walking to your car, into the grocery store or into work.

So, if you go to the mall, don’t forget your sunscreen for that long walk from the  car to the door.  And don’t forget to reapply before you walk back to the car if you happen to stay in there for a couple of hours.

But what about vitamin D?  A lowly SPF 8 reduces vitamin D synthesis by 90 percent, so your sunscreen-slathered walk from the car to the store gains you no vitamin D. Where should you get it?  Well, if you ask the question, the good doctors start finger wagging.

And don’t make the vitamin D argument, which says sun exposure is necessary to absorb the highly important vitamin. Just take a vitamin supplement

Okay.  But Dr. Holick writes

when you are exposed to sunlight, you make not only vitamin D but also at least five and up to ten additional photoproducts that you would never get from dietary sources.

What about these additional photoproducts?  I’m sure nature didn’t endow us with the ability to make them for no reason.  And you can’t get them from supplements, so where do you get them if you don’t get some sun exposure?  The answer is, you don’t.

Plus, vitamin D supplements are just that: supplements.  They supplement the vitamin D you make yourself – they don’t replace it.

If, God forbid, you actually do go out in the sun, the good doctors recommend a sunscreen with a SPF 30 if not higher.  And don’t just smear a little on, they recommend at least two ounces of the stuff (about a shot glass full).  Plus they want you to put it on at least 20 minutes before going outside and re-slather yourself with another shot glass of the stuff every two hours.

Just this week, New York Times health columnist Jane Brody jumps into the rolling river of mainstream dermatologic nonsense and is swept along to her own idiotic conclusions.  Her greatest fear is sun-exposure-driven skin cancer, not just premature aging and skin spots, although she does comment on those.  Using anecdotal information she would decry in others, she brings her own relatives in as examples.

My paternal grandmother, who lived a block from the beach in Brooklyn and swam daily in the years before sunscreens, had what we called “elephant skin” by her 50s.  But my 90-year-old Aunt Gert, who lives nearby and winters in Florida but never went to the beach or sat in the sun, has the skin of a 60-year old.

Well, I guess that settles that.  And I’ve got a great uncle, still going strong at age 87, who drank like a fish and smoked two packs a day for most of his adult like.  According to Jane’s logic, maybe we should adopt Unc’s lifestyle.

The real meat of Jane’s piece is that since the sun makes us feel better and look better (the vast majority of people surveyed say a tan is more aesthetically pleasing than fish-belly white), people are becoming addicted to the sun.  And, as with any addiction, sun addiction is tough to break.

Jane worries that sun addiction leads first to overexposure then to skin cancer.  She quotes the oft-cited statistic that this year will see

3.5 million new cases of superficial but often disfiguring skin cancers, and an estimated 68,720 melanomas

I think she’s overstating the case for these superficial skin cancers being “disfiguring.”  Most are basal cell or squamous cell skin cancers, which are virtually non-malignant and can be removed without leaving much – if any – evidence of their ever having been there. Both MD and I have had basal cell cancers removed from our foreheads in minor office procedures without any evidence they were ever there.

The 68,720 melanomas, which are malignant, are much more attention getting.  But, there is no evidence that excess sun exposure causes melanoma, while there is data showing that chronic sun exposure and vitamin D seem to prevent it.

Just for grins, let’s go along with Jane and assume that melanoma is caused by the sun.  If we go to the latest cancer statistics from the American Cancer Society (ACS), we find that 8,700 people died last year from melanoma.  We know that sun exposure and vitamin D (along with maybe the other 5-10 photoproducts we synthesize from sun exposure) help prevent breast, colon and prostate cancer.  If Jane is correct and we avoid the sun, we run less risk of being one of the 8,700 people who perish from melanoma. But what about the other side of the coin?

According to the same ACS statistics, last year 40,230 people died from breast cancer, 32,050 from prostate cancer and 51,370 from colon cancer. So, on the one hand, we have 8,700 people die of a disease that probably isn’t related to sun exposure while on the other we have 123,650 who died from cancers known to be related to lack of sun exposure.  I don’t know about you, but I’ll go with the sun exposure, “disfiguring” superficial skin cancers be damned.

Plus, we didn’t even mention the devastating disease multiple sclerosis, a disease much more common in those with little sun exposure.  There are between 250,000-350,000 new cases of MS diagnosed each year. I’ll be happy to accept the risk of a few minor cancers to significantly reduce my risk of developing MS.

The danger of too much sun is minimal – the danger of too little sun is enormous.  I know which side I come down on.  The health trade offs remind me of a corny joke I heard when I was a kid that made such an impact on me that I’ve remembered it since.  The joke (or parable) was about economic issues, but it applies to sun exposure as well.

Did you hear the one about the guy who took big steps to save his twenty dollar shoes and ripped his 50 dollar pants?

It’s just another way of saying don’t be penny-wise and pound foolish.  In terms of our current discussion, we could say, Don’t be skin-cancer-wise and colon-breast-prostate-foolish.  Which is exactly what the misguided perspective of most dermatologists would have us be.

Painting: Olive Trees with Yellow Sky and Sun by Van Gogh

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95 thoughts on “Heliophobe Madness

  1. Great post. Here’s what happens to you short-term when you follow these dermatologists’ advice:

    “Paltrow writes, “I suffered a pretty severe Tibial plateau fracture a few years ago (requiring surgery) which lead the orthopedic surgeon to give me a bone scan, at which point it was discovered I had the beginning stages of osteopenia.”

    “This led my western/eastern doctors in New York to test my Vitamin D levels, which turned out to be the lowest they had ever seen (not a good thing).”

    http://www.sfgate.com/cgi-bin/blogs/sfgate/detail?blogid=7&entry_id=66017

    Have you looked into the relationship between sunburn and omega-6 intake?

    • Great Article that came out today on the skin cancer scare tactics used by dermatologists. Even though the U.S. has only 4.5% of the world’s population, we allegedly account for 52% of the world’s melanomas. Dermatologists regularly state that melanoma is the fastest growing cancer in women between the ages of 25 to 29 — ignoring men, the group most at risk, altogether. Is there a correlation between young women being the largest consumers of skin care products as well as being the largest demographic group scared into dermatologists’ offices to have moles removed? (And Botox injections–the fastest-growing procedure in dermatology today.) Is there a connection between dermatologists getting more press over skin cancer than heart disease or other top cancer killers that have no connection to the multibillion-dollar cosmetics industry?

      http://www.huffingtonpost.com/harmon-leon/is-profit-behind-dermatol_b_640929.html

  2. My husband has been diagnosed with Disseminated Superficial Actinic Porokeratosis (DSAP), pre-cancerous skin lesions, and the dermatologist tells him he has to stay out of the sun, of course. They did say that it’s incredibly rare for them to become malignant. And come back every year for checkups. The ironic part, to me, is that one of the more recent touted cures is application of vitamin D3 analog cream to the skin. It’s hard to know what the best option to follow is, since he never seems to tan, only burn or freckle.

  3. A very interesting post. I come from the land of sunburn and melanoma (New Zealand). My mother actually died from this and I have another friend at present who is dying from it. One thing that always amazes me though is that it appears the most dangerous melanomas are on the soles of the feet or between the toes etc (which is where my friend’s started). If these are from the sun alone then just how much exposure do these parts of the body get?

    I agree that we need to be sensible and apply some sunscreen before embarking on a day at the beach and I do wear an SPF15 face moisturizer every day but that is it. I love to walk in the sun and be out feeling the wonderful, healing effects the sun has. I think it is one of the most amazing, uplifting things we can do. Heck from what I read these days everything will kill you and I’m sure it is turning some people into a whole new type of obsessive compulsive personality.

    Oh and about my mother – she did not sun bath, she wore sun hats and bought us all up to be sun smart long before sunscreens existed. She did have very pale skin though and did get burnt badly as a child which apparently did most of the damage.

    • Here in New Zealand they call it “Sun Smart”‘.
      Sun Smart is Vitamin Stupid.
      Do we know anything about the melanoma stats in countries closer to the equator? If the heliophobes are right, the entire populations of those countries will have cancer, and the healthiest individuals will be women in burqas. Well, we do know that women in burqas are more susceptible to cancers, due to minimal vitamin D. I wonder if these statistics include melanomas?
      I would like to see if these is any correlation between consumption of gluten grains and incidence of melanoma. There is a definite link between gluten and MS. And one effect of low vitamin D is to make people more sensitive to allergens. Recently in NZ there was the case of a young boy with multiple allergies, asthma, eczma etc. His (very on-the-ball) doctor tested his vitamin D (he was pale and obviously didn’t get out much, a typical “Sun Smart” victim). The Doctor prescribed high-dose D3 – and the child’s sensitivities practically disappeared.
      It’s possible that low vitamin D triggers MS by activating the genes for celiac disease or an “atypical” gluten sensitivity (interferon can also do this). In this case low vitamin D plus gluten would also trigger other autoimmune diseases (both do seperately, but I’m hypothesising that the interaction is especially dangerous). The countries that had the first agriculturalists had almost year-round sun. Perhaps they were were less sensitive to activation of thse genes. But gluten is dangerous enough without them. It’s only a matter of time before a loaf of bread comes with health warnings similar to those on a packet of cigarettes.

  4. as always excellent post! At the beginning of summer here in bklyn, ny i would be out on the deck for about 25 minutes, then cover up. i did this every sunny day and i never once got burned, instead i developed a nice, mild brown tan. This tan now allows me to spend much more time in the sun without getting burned. Sitting in the sun and not getting burned is a wonderful, natural feeling. One that, especially here in the city, is sometimes hard to get. So many people have forgotten how good it feels, or never even learned. They immediately associate sitting/playing/reading in the sun with getting burned.

  5. Heliophobe and Cholesterolphobe – Not Real Doctors, Just Narrow Specialists

    This article suggests to me that the Heliophobes are not real people doctors, but are narrow specialists who are doing their darndest to keep their specialty blameless for patient deaths – and aren’t interested in how many people die, so long as the blame doesn’t fall on Dermatologists (and sunshine).

    Of course the Cholesterolphobes are those that will reduce cholesterol to unhealthy levels, but so long as the deaths aren’t from cardiac events, they hold their specialty blameless as well.

    In short, I see narrow specialists out to practice(and hold blameless) their specialty but not to be real people physicians who are concerned with the total well being of their patients.

    It is a sick situation. There are probably more examples than this just waiting to be identified.

  6. Since I burn like a bun on a broiler, I limit my sun exposure. But even I venture across parking lots and sit by the window without putting on a space suit.

  7. Good post. I have several hundred moles (dozens of large ones) and I still go out in the sun. I use sunscreen on my face and at the beach more to prevent burns that keep the sun off me– sue me I don’t like blistering sunburns. Otherwise, I let the sun rays fall where they may and will seek them out.

    Vitamin D has made a huge difference in the vigor of my immune system. I love the stuff.

    Now, I have a question. I low carb and my cholesterol doesn’t improve. It doesn’t get worse, but my HDL is in the toilet. I’m lucky if it’s 30.

    Very brief medical history: have taken lots of prednisone for asthma resulting in Iatrogenic Cushings and adrenal suppression and ended up with PCOS.

    Is there anything you would suggest in this situation? Am I alone in this?

    I’m about to start Slo-niacin and am considering drinking red wine regularly (which I hate alcohol but want to avoid statins more).

    All the expert data says my cholesterol should improve with low carb, but it doesn’t. It’s the same whether I’m fat or thin, exercising or not, strict low carbing or eating carbs.

    What gives? I would be interested to hear your thoughts.

    Thanks
    M

      • Really? I know the healthfulness of saturated fat is in dispute among paleos and low carbers. Save for avocados and coconuts, I do not like vegetable sources of fat, not even olive oil. I prefer butter, cream, and lard.

    • I’ve gone progressively lower and lower carb over the last 10 years, and now am carnivorous only. (last 2 plus years)

      I am a 42 yr. old male who 10 years ago weighed 275 and had an HDL of 34. Almost every year it has gone up, as I’ve increased my sat. fat.

      I eat as much beef fat as I can find! My HDL was just tested a couple weeks ago….78!

      As for the sun, I completely filled up my Vitamin D stores this weekend, 3 whole days with wall to wall sun! (No burning, for one because I had a pretty dark base already built, and 2 because ever since I went zero carb, I’ve noticed that it takes a LOT for me to burn….even when venturing out for my first “laying out” session in March, here in Upstate NY.

      • I’ve never thought of that before! When I was a kid I’d turn a pretty dark shade of tan and my hair went almost white every summer. Then, I discovered computers and eventually got my own about 10-15 years ago, and ever since I’d almost instantly get burned (shoulders and ears, mostly) whenever I went outside.

        Now that I’ve been lowcarbing to get my type 1 diabetes in reins (and get some very cool muscle definition, heh), I’m not burning at all! Granted, I live in Norway so summer here ain’t exactly Florida but most people can’t spend more than a couple of hours outside without sunscreen and not get burned, let alone 5-6 whole days in a row sunbathing, BBQ’ing, etc. I can, and I suspect it’s because of my new, healthy lifestyle. =D

    • Michelle- more important than the individual numbers in a lipid panel are the ratio comparisons… when you low carb the triglycerides usually go down and the ratios improve

      the following forum post gives some good info about cholesterol for low carbers… http://www.marksdailyapple.com/forum/showthread.php?4723-Cholesterol-A-Primer-(Attempt-2)

      garlic, cloves and cinnamon are all natural foods that help lower cholesterol… you said you were considering drinking wine but didn’t like alcohol… why not supplement with resveritrol or grape seed extract?

  8. I’ve had numerous basal cell carcinomas on my face. The first was removed by a plastic surgeon instead of a dermatologist. He never mentioned sun screen although he did say that the skin cancers probably started developing when I was a teenager after too much sun exposure (I was in my 50s at the time). I also was very sun sensitive as a teenager – 5-10 minutes of sun exposure would raise large blisters on my face, neck, and arms. Fortunately I outgrew that.

  9. Off topic–but I was wondering which of the Gore’s will be moving down the street. Bet you’re hoping it’s Mrs. Gore. Good luck!

  10. I never had any sun allergy before I started using the sunscreens.
    I guess, sun is like wine – ‘moderate’ is the key word.

  11. Awesome post Jim B. Whole health doesn’t seem to be in the skill set. Similar maladies affect other professions, but it seems more profound and tragic when dealing with health and wellness.

  12. Great post! As someone who, not long after moving to sunny So California, had MOHS surgery (outpatient) to remove a basal cell carcinoma on my nose in my 30s (repaired with a skin graft because at that age my skin was still too young and tight to repair with a simpler skin flap), I fell for the heliophobe madness for almost ten years. In hind sight it was like living in a cave and I’m so glad I regained some sun sense a few years back.

    I still take great care not to burn (esp protecting previously sun-damaged areas with clothing and/or hi SPF sunscreen) but I find a bit of measured midday unprotected sun exposure on a regular basis to be very good for my overall wellness (improved sleep, mood, and resistance to infectious illness). I test my 25 (OH) D level at least twice a year to make sure it doesn’t go too low and supplement with some Vit D3 (the careful sun exposure alone doesn’t seem to make quite enough Vit D esp in winter).

  13. This advice from our provincial health department

    Avoid sun exposure
    The best way to prevent a sunburn is to avoid sun exposure.
    Stay out of the midday sun (from 10 in the morning to 4 in the afternoon), which is the strongest sunlight.

    A few days ago a dermatologist issued dire warnings on the local news to avoid any and every form sun exposure. According to this ‘expert’ any form of sun tan is skin damage and that people’s vanity is putting their lives at risk.

    I came across an interesting paper recently that found that being deficient in vitamin D actually makes one more susceptible to sun burn and that the burning process accelerates the synthesis of vitamin D. This seems to be consistent with my experience. My last 25(OH)D test was 90 mg/dl. Ever since I got my blood levels above 40 ng/ml my tendency to burn easily stopped.

    • My entire goal everyday is to get myself and my kids (age 1 and 2.5) into the sun between 10 and 4. :)

      Guess what? They eat tons of saturated fat and very little junk and THEY DON’T BURN! With no sunscreen. Imagine that. They’ve never had a drop of the stuff and I hope never will.

      I used to burn badly as a kid…eating SAD. Now I eat WAP and my back/shoulders still burn sometimes…but my legs, arms, face…don’t. Ever. People are shocked. But, um, it’s pretty sweet. My kids stopped getting little colds when they were able to get into the sun more. And they’ve been exposed to both Hand, foot and mouth disease as well as strep throat in the past few weeks and haven’t gotten either.

      Ah, sun and vitamin D, I love you.

  14. Dr. Mike,

    Great post!

    Penny wise and pound foolish is exactly right (referring to the fear of the sun, of course).

    I’ll take my chances doing what people have been doing for-freaking-ever (getting sunlight) and avoid the modern “improvements” (avoiding the sun, gobbling D supplements and smearing chemicals liberally all over exposed skin).

  15. What advice would you give someone who lives in the Pacific NW? We are still sitting in 65 and rainy even though summer has officially begun. We can’t get vitamin D even if we tried! I’ve lived here all my life and I am definitely not one who “tans well” more like “burns well” even with smart sun exposure. Are we doomed?

  16. Excellent post.

    You said “I think she’s overstating the case for these superficial skin cancers being “disfiguring.” Most are basal cell or squamous cell skin cancers, which are virtually non-malignant and can be removed without leaving much – if any – evidence of their ever having been there.”

    I have seen some devastating basal cell and squamous cell skin cancers of the head the eyelids. I have seen people who have lost eyes, nose and ears to these cancers. These are not benign on the face and need to be taken care of in the earliest stages.

    • I agree about the ones let go too long. Many dermatology texts have horrific photos of these bad basal and squamous cell cancers, but these days few people would let one get that bad.

  17. All I have to do to dismiss health information is see the name Jane Brody attached to anything. I swear if she said it was pouring out, I’d go to the window to check. Too bad she has such a large bullhorn, filled mostly with bull. Thanks for the great posts, Mike – we’ve missed your sensible, level-headed, no-nonsense writing and commentary.

  18. In addition to the health benefits you’ve discussed, being out in the bright sunshine often gives me a bright outlook and feeling. Great post, hope to see more. Jim

    • Here’s an interesting connection; the hormone that stimulates melanocytes to tan comes from a precursor peptide, pro-opiomelanocortin, that also breaks down into beta-endorphin. So it may be that when your body has to tan it makes more POMC, and more endorphin is also produced as a result. So you not only look better, you feel better too; and because endorphin is an immune hormone, immunity increases; and this – as well as vitamin D – may be the winter flu factor.
      It may not be co-incidence, because perhaps endorphin’s immune effect is needed to cancel out the increased cancer risk from UV.

  19. “there is no evidence that excess sun exposure causes melanoma”

    Really?

    Really??!!

    I say that because… it’s contradicts everything I’ve heard, read and been told by “medical media” in the UK for the past twenty years.

    Are there any studies disputing the link?

    If there really is no link then why are people being indoctrinated with this false information?

    • I’ll bet you’ve been told by the same media that saturated fat is bad for you and that low-carb diets will cause you to develop heart disease.

      • Yes to the saturated fat, no to the low-carb diet, but neither really answers my question.

        Where are the studies to support your statement that there’s no correlation between sun explosure and melanoma?

    • Victoria in the UK: Check out Barry Groves website Second Opinions and read his book Trick and Treat. He’s British, so his references cite more evidence from the UK and more examples of the idiocy of health officials in your country. His book devotes a chapter to the topic of sun exposure.

    • Victoria you really do need to update on your information and i am not talking about that mainstream crap you have been digesting so far.i suggest you read more of Dr eades articles and similar like minded individuals then you might be able to make a informed dicision.

  20. Hello Dr. Eades, What is your recommendation for children. I have 4 I only apply sunscreen in the beginning of the summer to avoid a burn. After my kids get a nice tan, they never burn and I never apply the sunscreen. Do you recommend what I am doing? Also, should I be giving my kids supplements in the winter and if so how much… brand?

    Most of our friends run around and re apply all summer long and their kids never seem to get that healthy tan.

    Thanks, Michelle

    • I believe that the estimated new cases annually is around 10,400 (they quoted about 200 per week). I thought that 250,000 sounded a little high too… :) Great post tho, and I too would be interested to see more about the melanoma not being caused by sun exposure. It’s not that I don’t believe you, just that it’s intriguing.

  21. When I look up photoproducts other than D3 online and in my biochemistry textbooks I only come across thymidine dimers and other DNA mutations. These are the “bad” photoproducts (lucky flukes of evolution aside) that antioxidants reduce. I’m happy to get lots of sunlight because the effect on hormone regulation (the melatonin switch) seems to be beneficial as well as the D3. Plus, of course, the things I can do in the sun. If there are other beneficial photoproducts no-one knows about, they are likely to be in vit-D rich foods, such as salmon and chlorella.
    If someone is sun-sensitive in childhood but now now, it may well be because they eat more vegetables now, or take antioxidant supplements.
    I think it likely that when too much hot sunlight hits skin inadequately protected with antioxidants (including tans) for too long, enough thymidine dimers are formed to potentially create cancerous cells. Even so, what prevents the immune system taking care of these? My guess is immunosuppressive toxins such as gluten and casein peptides, excess insulin and glucose from high-carb diets, drugs, including excessive use of coffee and NSAIDs, and not enough immune-boosting foods.

    • “other health problems related to exposure to strong solar radiation, include the photodegradation of certain vitamins such as riboflavins, carotenoids, tocopherol, and folate.”
      also
      “In addition to melanin deficiency, the molecular weight of the melanin polymer may be decreased by various factors such as oxidative stress, exposure to light, perturbation in its association with melanosomal matrix proteins, changes in pH or in local concentrations of metal ions. A decreased molecular weight or a decrease in the degree of polymerization of ocular melanin has been proposed to turn the normally anti-oxidant polymer into a pro-oxidant. In its pro-oxidant state, melanin has been suggested to be involved in the causation and progression of macular degeneration and melanoma.[17]

      ABSTRACT
      The human melanocyte is continuously exposed to intrinsic and extrinsic sources of reactive biochemical species, but is finely tuned via the intrinsic anti-oxidant and radical properties of melanin to suppress the build-up of an altered redox phenotype. We propose that this control is lost during melanomagenesis and inappropriate redox-sensitive transcriptional factor activations occur which result in enhancement of an anti-apoptotic phenotype in the transformed cell. This conceptual framework offers testable steps to determine the role of redox alterations in the carcinogenic evolution, prevention and treatment of melanoma and other diseases of the melanocyte.

      ABSTRACT
      The human melanocyte is continuously exposed to intrinsic and extrinsic sources of reactive biochemical species, but is finely tuned via the intrinsic anti-oxidant and radical properties of melanin to suppress the build-up of an altered redox phenotype. We propose that this control is lost during melanomagenesis and inappropriate redox-sensitive transcriptional factor activations occur which result in enhancement of an anti-apoptotic phenotype in the transformed cell. This conceptual framework offers testable steps to determine the role of redox alterations in the carcinogenic evolution, prevention and treatment of melanoma and other diseases of the melanocyte.
      ABSTRACT
      The human melanocyte is continuously exposed to intrinsic and extrinsic sources of reactive biochemical species, but is finely tuned via the intrinsic anti-oxidant and radical properties of melanin to suppress the build-up of an altered redox phenotype. We propose that this control is lost during melanomagenesis and inappropriate redox-sensitive transcriptional factor activations occur which result in enhancement of an anti-apoptotic phenotype in the transformed cell. This conceptual framework offers testable steps to determine the role of redox alterations in the carcinogenic evolution, prevention and treatment of melanoma and other diseases of the melanocyte.
      ABSTRACT
      The human melanocyte is continuously exposed to intrinsic and extrinsic sources of reactive biochemical species, but is finely tuned via the intrinsic anti-oxidant and radical properties of melanin to suppress the build-up of an altered redox phenotype. We propose that this control is lost during melanomagenesis and inappropriate redox-sensitive transcriptional factor activations occur which result in enhancement of an anti-apoptotic phenotype in the transformed cell. This conceptual framework offers testable steps to determine the role of redox alterations in the carcinogenic evolution, prevention and treatment of melanoma and other diseases of the melanocyte.

  22. One thing they never talk about in canola oil. Canola is known to cause photosensitivity in, say, goats. I used to be very sun sensitive, and would break out in “sun dermatitis” when I went out into the sun. But when I stopped using canola oil, I stopped having any problems. We never use canola now, and in the last 10 years, we’ve had zero cases of sunburn or even getting a bit red.

    So my take is that the high rates of skin cancer that are happening are the result of canola, and maybe other dietary factors that make us too sun sensitive!

  23. Whenever a magazine interviews a doctor or scientist for its health page, they don’t question the “wisdom” being handed down; yet if they review a film or a book, they feel free to point out its flaws. Why this devout attitude to individuals as flawed as any others?
    In “Mysteries” Colin Wilson writes a great chapter called “The Curious History of Human Stupidity”. It’s about how all the most respected scientists in history are actually the ones that shut down discussion about facts we now take for granted. The people who actually had the right idea, are still forgottten. Linnaeus dismissed Maillet’s theory of evolution based on the fossil record. Cuvier destroyed Lamarck for proposing evolution. Lavoisier refused to accept the existence of meteors when one fell in his lap, so to speak. Time and again the famous, respected bigwigs of science opposed and persecuted scientists who were on the right track – centuries after the Church had accepted that they might be correct and had a right to their theories. Wilson suggests that the very personality that makes a for succesful scientist tends to make for extreme territoriality and hostility to new ideas, and has lead to acts of dishonesty and malice throughout the history of science. Edison, it seems, was something of a psychopath, who ripped off Tesla’s patents, as well as the patenting and stealing the animation ideas of Winsor McCay, who had refused to patent them as he believed they should be public commons. Edison then charged McCay to use his own invention. He also bootlegged Méliere’s Trip To The Moon, bankrupting the pioneer special effects filmaker. Yet Edison is still an icon, while the creative scientists he victimised, despite their achievements, which in each of these 3 cases are more influential in today’s world than Edison’s, are marginal figures.
    The more influentual a scientist is, the more likely that they are suppressing or ignoring some idea more advanced than their own, while papering over the cracks in their own theory. Perhaps single-mindedness and narrow-mindedness are not so far apart; perhaps those lab chemicals tend to preserve the brain at the stage of its first expansion, in all but exceptional individuals.
    For a look at what modern-day cutting edge medical research and development is like at the coal face, read Candace B. Pert’s “Molecules of Emotion”, about the discovery and development of the endorphin receptor, and its aftermath. You’ll never think about medicine the same way (however you think of it now).

  24. Interesting… I also live in the Pacific Northwest — like Kelly. In fact all the way over in the Olympic Peninsula. An area that gets so much rain it is actually considered a rainforest. I take D supplements at the recommendation of my doctor because of this.

    But my question is… I read quite a number of years ago that bathing, especially with strong soap, removes some of the skin oils necessary to properly make vitamin D when in the sun. And the article went on to say this is why some people, even in sunny climates, were low on vitamin D. Is there any evidence for this? Or was this just a theory that was later disproven?

    Should a person skip a shower now and then before sunbathing? Let those skin oils remain intact? Or is that so much nonsense?

    Love your blog!!! Thanks.

    • Dr. Mercola has posted many articles about sunshine and vitamin D…..in his article, “How Much Sunshine Does it Take to Make Enough_Vitamin D? Perhaps More Than You Think!” , the last paragraph he writes about how soap affects vitamin D absorbtion… Here is the link and last paragraph of that article…

      http://articles.mercola.com/sites/articles/archive/2009/10/29/how-much-sunshine-does-it-take-to-make-enough-vitamin-d-perhaps-more-than-you-think.aspx

      “Bathing
      It is important to remember, if you are using the sun or a safe tanning bed to obtain your vitamin D, that the vitamin D takes about 48 hours to be completely absorbed into your blood stream, and you can easily wash it off with soap and water.
      So you might want to consider only using soap in your armpits and groin for at least 48 hours to allow all the vitamin D to be absorbed. Personally I never use soap on my body other than these places (and my hands of course). Seems a waste to remove the sebum which is a collection of fatty acids on the skin. Over-washing can impair one of primary methods of staying healthy.
      Not washing my skin hasn’t ever seemed to harm it and many people comment that my skin is as soft as young child’s. I think that also has to do with keeping fat content optimized by avoiding processed fats and having high quality omega-6 and 3 fats.”

      The following link has 2 videos from Dr.Mercola about vitamin D… the 1st is a 1-hour lecture… in the 2nd he talks about how UVA and bathing affects the absorbtion of vitamin D in the body

      http://articles.mercola.com/sites/articles/archive/2008/12/16/my-one-hour-vitamin-d-lecture-to-clear-up-all-your-confusion-on-this-vital-nutrient.aspx

      • I would trust Dr. Holick on this one since he is the world’s expert on vitamin D. He says it can’t be washed off. It’s not a matter of the oils on the skin – it’s a function of the UVB rays on the skin.

  25. Dr Eades,

    I am a 46 yeqr old male with erythropoietic protoporphria, (For your readers, I’m missing an enzyme and consequently any sun exposure longer than ten mimnutes makes me feel as if I am burning in a fire for the next three days). Apart from being a vampire, I’m in excellent health. I’ve never discussed with a dermatologist the necessity of taking large doses of vitamin D and wonder if I should. My diet is ”paleo,” ( vegetables, fish, meat, and fruit. I do run in the morning at 6:00 am and that’s as much sun as can take; surely it is not the ”recoomended” amount

    Best

    Blair Thomson

  26. And my 54 yo husand who grew up in Florida and constantly burned himself over and over until he was as dark as he could be hardly has nary a wrinkle or spot on his face.

  27. My lab work came back vitamin D, 25-OH, total 72
    vitamin D, 25-OH, D3 72
    Vitamin D, 25-OH, D2 <4

    Problem is, it's Quest Diagnostics. Have they gotten any better or should I take this result with a grain of salt?
    I've been trying to supplement 1000 IU/25 lb body weight. Almost everything else seems to be within reference ranges except I'm now Hypothyroid.

    btw I was diagnosed with diabetes in 2004 with A1c=12.3% and now it's 5.5%
    total Cholesterol 151
    HDL 86
    TGL 47
    LDL (calc) 56
    I tried to run this through the Iranian formula and came up with LDL 35.4
    151-86-35.4= 29.6 I'm assuming my VLDL is still in the vicinity of 9-10.

    My question: is the rest of it supposed to be IDL, chylomicrons or what? Are there some other particles involved?

  28. There’s a wonderful lady in Florida who makes an organic oil that allows one to tan naturally without burning most of the time. (For long exposures on particularly bright days, I apply a little spf 50 to the tops of my shoulders as I have fair skin) I have a tan for the first time in 30 years.
    If you call Linda at 772-349-4638 she’ll tell you about it and if you send her a check she’ll mail it to you. It’s more expensive than sunscreen. The last I bought was $16. But that’s peanuts compared to other things I spend money on.

  29. Does your skin feel dried out after showering? Do you need to apply skin lotion all the time? If so, ditch the “strong soap” and choose something very mild. I cannot see that there is anything wrong with taking a shower unless you overdo it on the soap. Shower gels have never worked for me, high-quality soap works fine.

  30. good lord i never use sunscreen….and i never get a sunburn. all this alarmist nonsense just to create the need for a product we never would have bought…makes me crazy!

    and great choice of a painting for this article…van gogh did his best work when supposedly driven insane by overexposure to the sun!!

    happy 4th!

  31. Hi Dr Mike,

    I was wondering if you had heard of a ‘H.L Sam Queen’, who is another big advocate of minimising Vit D as much as possible due to its role in chronic disease and calcium imbalance, stating that most peaple have an excess in vit D. His regime is completly different from the marshall protocol and focuses on free radical therapy. I find it all a bit hard to swollow considering the evidnece contrary, do you have any thoughts on this?

  32. Hi Dr Eaders,

    I was wondering if you had more information about the nature of these “photoproducts”. Like somebody else said, most of the better described products are related to DNA damage and other negative aspects. Regarding this, I believe that antioxidants would tend to be upregulated in response, therefore adding argumentation to the necessity to progressively increase skin exposure to the sun. If these photoproducts are all products of UVs’ effects on cholesterols, then they might be molecules that resemble very much vitamin D. The vitamin D3 supplements I have seen were extracted from wool. If these other products are akin to vitamin D, then I would expect the purification process not to be able to segregate them. Hence these other photoproducts might be in the supplements after all.

    By the way, I’m a student doing his master on enzymatic antioxydants in the lung with emphasis on those dependent of selenium (well, my thesis is more precise than this but I spare people of the details). The idea that dietary antioxidants are essential seems frivolous when one takes a look at all the enzymatic antioxidants (glutathione peroxidases, peroxiredoxins, catalase) and cofactors (glutathione, thioredoxin, etc.) the body makes and finely regulates. The philosophy “the more the better” has been proven wrong in many antioxidant genes overexpression studies, and oxidative stress regulation as a mean to transduce cellular signals go against the idea of oxidative stress being “the bad guy”. I’m not saying that plants can not have beneficial anti-infective and anti-inflammatory benefits that could even ease the body’s management of oxidative stress, but I don’t believe much in a direct antioxidant role. I stop derailing now :)

    • @ Max Thunder. Good stuff Max. I’m definitely a proponent of supplementing small-molecule antioxidants in disease states, because of my own experience in Hep C; but at the same time, you won’t get far if you neglect the mineral-protein based enzymes, peroxidase, catalase, dismutase x2. Selenium is an especially important mineral in HCV and HIV – you might be interested in Ethan Will Taylor’s research into viral selenium genes. http://www.springerlink.com/content/30131g24k52528pq/
      and his hypothesis at http://www.orthomolecular.org/library/jom/1997/articles/1997-v12n04-p227.shtml
      Selenium is the only trace element that’s directly encoded in DNA, (UDA stop codon alternative reading) and the only mineral there besides sulfur.
      Anyway, it is possible that the importance of small-molecule dietary antioxidants is misunderstood in humans because most animal models used are not as dependent, due to their ability to synthesise ascorbic acid on demand. A dog in the wild will have practically no carotenoids, polyphenols or tocopherols in its diet; these mere traces suffice, perhaps because ample ascorbate, lipoate, co-q10, glutathione etc. keep them in the reduced state more easily than is the case with us, and can in fact substitute for all but the vitamin function of tocopherol.
      Cells which have had antioxidant enzyme systems knocked out can be kept alive with extra small molecule antioxidants. Perhaps the opposite is also the case.

  33. Dr. Eades,

    I just read through this:

    http://www.nutritionandmetabolism.com/content/1/1/2

    It’s a study on the effects of a long-term ketogenic (plus hypocaloric) diet on endurance. I thought you might find it interesting; it actually shows that after an adequate adaptation period, the subjects improved their endurance and decreased their oxygen expenditure.

    I’m a big fan of your blog and an owner of Protein Power, thanks for what you do.

    -Eric, from Afghanistan

  34. Dr. Eades,
    I read this post with great interest, as I am reviewing about 20 brands of natural sunscreen (rated 0-3 at EWG’s database, mostly zinc oxide based) and sun protective clothing and publishing in 2 weeks. I’m guessing you think sun protective clothing is a load of malarky…but what of sunscreen? Is there a place for it at all?

    I’m sort of dangling between the cultural media that I was still listening to 2 years ago that says “sunscreen, all the time!” and the real food world that understands the need for vitamin D. Is there a balance between seeking shade, using sunscreen, and enjoying the sun? Thank you so much! I will certainly be linking to this article in my review as I try to determine the value of sunscreen, period.

    Katie Kimball

  35. Vindication from the deep south (Pacific, that is):

    MARAE MEMBERS SHED KILOS
    http://www.hawkesbaytoday.co.nz/local/news/marae-members-shed-kilos/3916934/

    Expect tearful moments of gratitude from some well-known Bay personalities on TV3’s 60 Minutes tonight.

    For the past 10 weeks, local health coach Ben Warren has worked with 27 men and women from Flaxmere’s Te Aranga Marae who have been battling with weight, high blood sugar and cholesterol levels.

    Mr Warren was approached six months ago by former All Blacks captain Taine Randall to help members of the marae.

    “Taine and his wife, Jo, had been on my programme and they wanted to share what they had learned with others,” Mr Warren said.

    The 27 participants lost an average of 8.7kg, with one losing a staggering 16kg in 10 weeks.

    Mr Warren said together with the considerable weight loss, the most significant results were the lowering of blood sugar levels, with at-risk participants moving from a type 2 diabetes danger zone to a much safer zone.

    “Diabetes is at epidemic proportions in New Zealand and the figures are particularly concerning for Maori, with one in five having type 2 diabetes or pre-diabetes.”

    In New Zealand diabetes causes 50 per cent of heart attacks, 33 per cent of strokes, 50 per cent of kidney failure, 50 per cent of blindness and 50 per cent of amputations.

    Mr Warren said that to be really effective, health programmes need to take in the genetic needs of individuals and he questions the “healthy food plates” recommended by organisations like the Diabetes Society.

    “The advice being handed out is that it’s okay to eat plenty of grains and carbohydrates but I would challenge this.

    “The refined grains can be really difficult for Maori to process.”

    Mr Warren said the programme proved to Maori that eating traditional foods, like boil-up and hangi were good for them.

    “Maori have been led to believe that fat and meat are bad for their health, but I don’t believe that to be true and we’ve got the results to prove it.”

  36. Here’s a good description of the BePure programme:
    this is actually the first time I’ve come across good sense nutrition in NZ; we’re pretty backward here (and twice as stupid for years of propaganda presenting our doctors as scientific pioneers).

    In this day and age for some one wanting to be healthy it is sometimes tough to know what the right things to eat actually are!
    Take butter for example, you can easily find PhD’s who recommend that you avoid butter, but you can also find PhD’s who recommend you eat butter.. So what is it?? Do you eat butter or margarine??

    In the Pure Health Revolution we provide you with a common sense model of nutrition that is based on evolutionary nutrition. Evolutionary nutrition involves looking at what we have actually eaten to live long enough and reproduce to be here today.

    Much of this research comes from the early work of Dr. Weston A Price who on his travels around the world found different cultures who were incredibly healthy and yet ate incredibly differently. For example, he visited Eskimo’s who eating their traditional diet of Seal (80% protein and fat) had low levels of heart disease and cancer. At the other extreme he visited tribes in Africa who ate predominately grains (80% carbohydrate) and once again were incredibly healthy.

    He even visited some untouched parts of New Zealand where the traditional Maori were eating their native diet (predominately seafood) and Dr. Price noted the exceptional, warrior like, physiques of these people, with absolutely no signs of the chronic ailments inflicted upon these people today.

    The Pure Health Revolution helps you establish what your genetic requirements for macronutrients (protein, fat and carbohydrate) actually are. Then teaches you the tools to be aware of your own body so you can fine tune your diet to fullfill your body’s requirements for energy, hormones and muscular re-building blocks.

    The Pure Health Revolution will also teach you what foods are nutrient dense and which foods you should be looking to avoid to maximise the absorption of all nutrients into your blood stream.

  37. Dr. Eades,
    On february the 4’th you wrote:
    ”I want to add my two cents worth on a bunch of the problems some Paleo dieters seem to develop. And I’ve got a post cooking on the thyroid and iodine. One on fructose, and one on saturated fat. Plus the analysis of the next stupid study that will inevitably pop up and seize the imagination of the mainstream media types who will shout it from the rooftops.”
    http://www.proteinpower.com/drmike/travel/back-from-mexico/

    Are you still working on those posts?

    In an old post you wrote that ”Once people become low-carb adapted–as I hope we all are–then the same thing happens if they go face down in the donuts. They don’t have the enzymes on board to deal with the sudden influx of glucose, and, as a consequence, their blood sugar spikes higher than it would on a person eating the same amount of carbohydrate who is already carb adapted.”

    http://www.proteinpower.com/drmike/uncategorized/low-carb-caveat/
    So I would like to know if taking digestive enzymes along with a cheating meal on a low carb diet would prevent that glucose spike and if yes if fermented borscht would be a good source of digestive enzymes.

    Thank you very much and I hope you respond even though it’s off topic.

  38. I am bemused by the fact that the same medical establishment that for years has been telling me not to take supplements because it’s so much better to get my vitamins from food is now telling me to ignore the greatest natural source of vitamin D (which is really a hormone) and “just take supplements.” Indeed, it’s pinning the ol’ Irony Meter.

  39. great post….

    However, I do have a question for those of us that do live in places where we get adequate sun.

    I’ve always lived in hot sunny climates and as a woman, have always worn sunblock on my face (on a daily basis).

    I think that in order to prevent wrinkles, it IS important to avoid too much sun exposure. Isn’t it? I’m in my 20s and this really seems like the only way to prevent wrinkles…am I misguided?

    Maybe wrinkles look distinguished on men, but not on women (unfortunately.)

    Is my thinking incorrect? I am just wondering when one draws the line?

  40. Like the statinators, I wonder how many of these “expert dermatologists” are in the back pocket of the sun screen manufacturers? The article you cited is overly paranoid.

    Like others, I’ve noticed that I don’t burn as readily since I’ve been on low carb.

    Dr. John Briffa once cited a BMJ editorial stating that, “…most [malignant] melanomas occur on the areas least exposed to the sun.” Of course, it was written by Dr. Holick.

    http://www.drbriffa.com/blog/2008/06/16/bmj-editorial-casts-doubt-on-the-notion-that-sunlight-causes-malignant-melanoma/

    I begining to beleive that the sun-skin cancer thing is mostly a ploy to sell sun screen.

  41. While I am the skin cancer poster-child, my father had skin cancer, and I have hit my 40’s without once achieving a tan. I burn every time that I spend more than 10 minutes in the sun, I am also, strangely, the one who does not believe in daily sunscreen use, and I realize that I need some incidental sun exposure. I am astounded at how afraid people are of the sun now. Moderation is the key.

  42. Today I nearly choked when I heard a dermatologist on the Dr. Phil Show state that the “sun suppresses the immune system” and that its only positive function was the synthesis of Vitamin D, “which you don’t need the sun to have. You can get that in a capsule form.” Of course there were the usual skin cancer/premature aging warnings as well. Sad.

  43. Hi,
    I live in LA, we have a pool and I enjoy the sun and warm summers. I use astxanthin supplementation daily. This is a supplement derived from seaweed that aids against inflammation and is reported to aid against sun burn. It is the supplement that is in shrimp that turns flamingos pink. One of the few antioxidants that cross the blood-brain barrier also fight machular degeneration. Does the vitamin D book offer alternate methods for blocking harmful solar effects and preserving beneficial effects,

    Thank you

  44. Wonderful written article and so true!
    BUT, unfortunately is message is drowning in the massive flood of sun-scare misinformation!
    Of course no dermatologist association has the resources to fund such campaign by themselves. The money comes from the big winners of this “game” the producers of sun-protection lotions. The initiator and largest contributor being L’Oréal.
    Join tannersrights.com and contribute to the disclosure of this scam.
    see also: http://www.youtube.com/watch?v=F_CrPZLbkE8

  45. I have a question and I was hoping you could help me out. I am taking 6,000 IUs of D3 a day, 2,000 with each meal. If I were to go tanning (and take a break from D3), would the tan I got last longer due to my higher D3 levels? I’m thinking of Dr Jablonski’s work on D3 and Skin Color and I remember reading somewhere that dark skinned people who live in cold environments often get a lot of D3 in their diet, so their skin color doesn’t become more pale over generations.

    • I don’t think the tanning process has anything to do with vitamin D3 consumption or levels. In other words, I don’t think taking vitamin D3 will make a tan last longer.