vitaminD and the sun

Seasonal affective disorder & vitamin d

Saskatchewan is known for its long, cold winters. As the temperatures decrease, so do the daylight hours, significantly diminishing the amount of sun we might see each day. To add to that, to avoid the cold, we spend more time indoors and the time we do spend outside has us wrapped from head-to-toe to keep warm. This means less sun exposure and therefore reduced opportunity for us to synthesize vitamin D from its light. For some people, the change in seasons also brings on the “winter blues” also known as Seasonal Affective Disorder (S.A.D.). It is currently thought that a combination of physiologic, psychologic, genetic, and environmental factors play a role in S.A.D., one of them being vitamin D deficiency.

What is seasonal affective disorder?

Also termed “S.A.D.”, Seasonal Affective Disorder is a form of depression that typically occurs in the winter months when our exposure to sunlight is limited. Approximately 2-3% of Canadians will experience S.A.D. at some point and 15% more will experience a milder version of the condition.

There is a natural tendency to slow down in winter compared to the high-energy lifestyles we tend to carry on in summer months. However, if you notice you are feeling particularly low or experiencing the signs & symptoms below, it might be time to consider consulting a healthcare professional for an assessment.

Signs & Symptoms

• Feelings of hopelessness & sadness

• Thoughts of suicide

• Oversleeping

• Cravings for sweet or starchy foods

• Weight gain

• Fatigue/low energy

• Decreased physical activity

• Difficulty concentrating

• Irritability

• Increased sensitivity to social rejection

• Avoidance of social situations

In S.A.D., these signs and symptoms appear and disappear at about the same time each year, and the sad, despairing mood:

• is present most days and lasts most of the day

• lasts for more than two weeks

• impairs performance at work, school or in social relationships

Vitamin D - the sunshine vitamin

Vitamin D, which actually functions more like a hormone, acts on receptors in every tissue in the body including the brain and immune system. As it is a fat-soluble vitamin, we get it through diet from sources such as fatty fish (sardines, salmon, tuna), eggs, and liver; and are also able to synthesize it through our skin when we get sufficient exposure to the sun. As such, vitamin D levels have been shown to fluctuate with exposure to sunlight. Levels tend to decline from fall to winter, and are naturally lower the further north you live from the equator.

Vitamin D has many functions within the body. It is needed for calcium absorption (healthy bones, teeth), healthy immune function, and also has a role in the release of dopamine and serotonin - signalling molecules that, in the brain, are associated with drive, pleasure, and happiness.

So, how much vitamin D do you need?

Health Canada recommends a daily dietary intake of 600-800 IU’s of Vitamin D for adults. However, according to their statistics, most Canadians are not achieving this. While we also know sunlight does provide Vitamin D, here in Saskatchewan, the exposure we get at our northern location is often inadequate, especially in the winter months. Vitamin D levels also decrease with age, skin pigmentation, liver and kidney disease, obesity, certain medications, genetic mutations and other conditions.

How do I know if I’m getting enough vitamin D?

Luckily, there is a test for that! A simple blood test can assess whether you are getting sufficient amounts of vitamin D, or if supplementation may be indicated–or, in some cases, contraindicated. There can be too much of a good thing especially when it comes to supplementation. Vitamin D toxicity related to excessive long-term intake of vitamin D can cause hypercalcemia and related symptoms such as confusion, apathy, vomiting, abdominal pain, pathological calcification, increased thirst and increased urination. It is also important to note that everyone metabolizes vitamin D differently, so some people can experience vitamin D toxicity even at lower doses that are considered safe for the general population. It is always recommended to consult a healthcare practitioner before implementing any new health regimen to see if it is right for you, including vitamin D supplementation.

If you are experiencing symptoms of the “winter blues” or are curious about your vitamin D status or other natural approaches to mental health, you are invited to book a consult with myself or one of my colleagues to discuss your healthcare options.

We look forward to working with you!

In health, Jacalyn Sieben, ND

References:

1. CAMH. (2019). Seasonal affective disorder (SAD). Retrieved from: https://www.camh.ca/en/health-info/ mental-illness-and-addiction-index/seasonal-affective-disorder

2. Canadian Mental Health Association, BC Division. (2013). Seasonal affective disorder. Retrieved from: https://cmha.bc.ca/documents/seasonal-affective-disorder-2/

3. Health Canada. (2012). Vitamin d and calcium: Updated dietary reference intakes. Retrieved from: https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/ vitamin-calcium-updated-dietary-reference-intakes-nutrition.html

4. Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P and Jones G (2018) Vitamin D Toxicity–A Clinical Perspective. Front. Endocrinol. 9:550. doi: 10.3389/fendo.2018.00550

5. Melrose S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression research and treatment, 2015, 178564. https://doi.org/10.1155/2015/178564

SUNSCREEN AND SAFE SUN GUIDELINES

It’s officially summer, and that means lots of sun exposure! A popular topic during this time is the use of sunscreen. This article will cover the benefits and risks of sun exposure, and how we can optimize the benefits while reducing our risks by implementing safe sun practices.

Why do we need to worry about sun protection?

Here’s a quick overview on how the sun affects our health.

The sun emits different kinds of electromagnetic radiation, including ultraviolet (UV) radiation (which is where we will focus our article). UV radiation can be classified as UVA, UVB or UVC. UVC radiation is blocked by the Earth’s atmosphere, so only UVA and UVB radiation reaches the planet’s surface (and us). UVB radiation is the type that plays a role in our body’s ability to make vitamin D.

Maintaining healthy levels of vitamin D is important for overall health, including supporting our immune system, maintaining healthy bones, and supporting mood balance. Since the sun is our main source of vitamin D, why do we need to be careful with sun exposure?

UV radiation is the single greatest risk factor in the development of skin cancers, which are some of the most common cancers in Canadians. UV radiation from the sun can damage the skin, resulting in sunburns, as well as skin aging, wrinkling and loss of elasticity. Therefore, balancing sun exposure to optimize benefits while reducing the risks is ideal! Below are ways to implement safe sun practices for adults, babies and children.

What you can do?

Avoiding the sun at peak times

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The sun’s rays are the strongest at midday, between 10 AM and 4 PM, which is when the risks are highest. Avoid getting sunburns and suntans, as these are the result of skin damage from the sun. Emphasize activities in the shade rather than in direct sun, or implement the use of shade from trees or umbrellas.

Use sunscreen

Sunscreen is used to protect the skin from the potential damage of ultraviolet (UV) radiation exposure from the sun. The Canadian Dermatology Association recommends a broad-spectrum (protecting against both UVA and UVB rays) sunscreen with a sun-protection factor (SPF) of 30 or higher. Generally, the higher the SPF, the more effective it is at protecting us from the sun (however, this does not mean that it is foolproof!). Sunscreen should be used on all exposed skin areas and reapplied as per manufacturer's instructions, potentially more often if swimming or sweating. Lip products containing SPF can be used to protect the skin on our lips.

Keep in mind that the skin is one of the body’s largest organs, and may absorb ingredients from the products we use on it. Using the Environmental Working Group’s (EWG’s) Healthy Living app can help you find clean and effective cosmetics and sunscreens. For a more information on “clean” sunscreen options, check out the EWG Sunscreen Guide!

Wear sunglasses and a wide-brimmed hat

Physical barriers to the skin, such as dark clothing, sunglasses and a wide-brimmed hat offer shade options and physical ways to block the sun’s rays. Sunglasses help protect your eyes from potential sun damage, including cataracts. Clothing that has a tight weave, darker in colour, and increased fabric weight and thickness are better clothing options to help protect against the sun’s rays.

Babies need protection too!

Babies’ skin and eyes are particularly sensitive to damage from the sun. Babies should be kept out of direct sun, and should wear hats with a wide brim and be dressed in loose fitting lightweight clothing that covers their arms and legs. These methods are ideal, however you can also use a baby-safe SPF 30 sunscreen. Make sure babies avoid getting tans or sunburns!

Can sunscreen decrease my body’s ability to make vitamin D?

Research suggests that sunscreen, especially when applied correctly and consistently and with a high SPF, can decrease the production of vitamin D, but only by a small amount. This may be because sunscreen does not perfectly block UVB radiation exposure to the skin, and therefore some vitamin D can still be made. If you are worried about not getting enough vitamin D, your naturopathic doctor can test your vitamin D levels and may recommend a vitamin D supplement, which provides a source of vitamin D without the radiation exposure from extended periods of time in the sun.

Written by Dr. Dana Kolenich ND

References:

[1] Queirós, C. S., & Freitas, J. P. (2019). Sun Exposure: Beyond the Risks. Dermatology Practical & Conceptual, 9(4), 249–252. https://doi.org/10.5826/dpc.0904a01

[2] https://dermatology.ca/public-patients/sun-protection/sun-safety-every-day/

[3] Li, H., Colantonio, S., Dawson, A., Lin, X., & Beecker, J. (2019). Sunscreen Application, Safety, and Sun Protection: The Evidence. Journal of Cutaneous Medicine and Surgery, 23(4), 357–369. https://doi.org/10.1177/1203475419856611

[4] https://www.aafp.org/afp/2000/0715/p375.html

[5] https://pubmed.ncbi.nlm.nih.gov/31069788/