This won’t be the first time you’ve seen an article about the sometimes hostile relation between dermatologists and vitamin D advocates on this forum, and it probably won’t be the last. These are important issues, and we intend to explore every facet of them to the fullest extent possible.
In 2008, the American Academy of Dermatology (AAD) first issued its position statement on Vitamin D. It did not mince words when it clearly stated that Vitamin D should not be obtained from unprotected exposure to ultraviolet (UV) radiation. Then, to make sure the point is driven home with a truly fear-inducing tone: There is no scientifically validated, safe threshold level of UV exposure from the sun or indoor tanning devices that allows for maximal vitamin D synthesis without increasing skin cancer risk. It’s clearly hard for any normal person to read this without essentially thinking, “Gosh, if even think about getting vitamin D from sunshine, I’ll get cancer.” And yet that’s not what is being said. What’s being truly said is that no one knows if there is a “safe” level of sun exposure. It is also saying that if you’re in the sun enough to generate vitamin D, you’re increasing your risk of getting skin cancer. But that doesn’t mean that you’re going to get skin cancer, no more than getting in your car and driving means you’re going to be involved in a car accident, but your risk is certainly higher than if you just stayed home. It’s important to see how dermatologists play on fear when talking about vitamin D.
The AAD statement also takes the time to discredit the association of vitamin D to a wide range of health problems. While plenty of epidemiological studies have noted these associations, what the AAD turns this into in its statement is the following: It should be emphasized that the causal relationship of vitamin D to these diseases has yet to be demonstrated with clinical trials. Again, no one was claiming causality, merely association. In other words, in many cases we don’t know yet if vitamin D deficiency causes some diseases and conditions or if it is a result of them. Either way, we know that vitamin D is essential to overall health, warranting further study of these associations to clarify its relation to other conditions. But the AAD statement doesn’t say any of that, only that causation hasn’t been proved.
In 2011, after a large Institute of Medicine review of the scientific literature on the association of vitamin D to a variety of diseases and conditions that did not state anything new, the AAD took the opportunity to update its position on vitamin D, which was not an updates at all, only an affirmation of all the points that were in the original statement to begin with.
A more recent dermatological perspective on vitamin D appeared in an issue of the Mayo Clinic Proceedings in 2012. In it, Dr. Henry W. Lim (head of the dermatology department at Henry Ford Hospital in Detroit) noted, Because of the known deleterious effects of solar and artificial UV radiation, UV exposure is not an appropriate way to achieve adequate vitamin D levels. Not surprisingly, it turns out that Dr. Lim has served as Vice President for the AAD.
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