What you need to know
As I write this week’s post I am sitting in my garden enjoying some unusually warm UK Spring sunshine and feeling very grateful on two counts: 1. the unseasonably good weather and 2. the fact that I am able to enjoy it without worrying about my #vitiligo. And as I soak up the rays it strikes me that a sunny garden is the perfect setting for this blog topic for reasons that will become obvious as you (hopefully) read on…
I recently visited my doctor on a general health matter which required various blood tests. The consultation had come to a close and I was just about to leave when she happened to mention, as an afterthought, that my levels of #vitaminD were borderline deficient and suggested I sit out in the sunshine for 20 minutes every day - in the middle of the day - to try to increase them. (If you aren’t sure what the connection is betweensun exposure and vitamin D I will explain in a moment.)
Of course this is the sort of medical advice most people would welcome as a great excuse for lounging about in a deckchair (and, since finding a vitiligo treatment that involves a certain amount of exactly that, I’m no exception!) But, the fact is that I have been taking a daily dose of vitamin D in my supplements equivalent to at least three times the recommended daily dose for years and I do already take every possible opportunity for sun exposure. So, when I told my doctor this, she concluded that, without the supplements and sunshine, I would most certainly be deficient. Of course, my medical records show that I had a long history of vitiligo. But, if my doctor was aware of any link between vitiligo and vitamin D deficiency she didn’t let on. So I decided that, once again, it was time for some more research into the subject.
Over the past few years I have come across plenty of vitiligo literature linking vitiligo to vitamin D deficiency but I was not clear as to which condition causes which (“chicken and egg” again). As it turns out, it appears to be a bit of one and a lot of the other! On one side of the coin, having vitiligo usually causes sufferers to stay out of the sun for fear of burning or drawing attention to their white patches by tanning the rest of their skin and this naturally results in reduced levels of vitamin D. But more interestingly, on the other side of the coin, research shows that individuals who have vitiligo, psoriasis and various autoimmune conditions have subnormal levels of vitamin D to start with. So, it seems that having vitiligo almost certainly means you are low in vitamin D in the first place and if you then also avoid sun exposure, as most vitiligo sufferers do, you are making a bad situation worse.
Before you get too depressed, I have come to realise that with every bit of bad vitiligo news there is some good news too because every problem flags up a potential solution. In this case, once you are aware that vitamin D deficiency is linked to vitiligo, an obvious solution is to take vitamin D supplements and also get more sun exposure. But do read on before dashing off to the nearest healthfood store, because it is not quite as straightforward as that. There is some homework to do first on the subject of this tricky vitamin!
Historically, the role of vitamin D has not been well understood but over the past several years it has become a hot topic, with new research papers appearing on a very regular basis leading to a much greater awareness in medical circles, and in the media, of its importance .
Believe it or not, scientists don’t always agree as to whether vitamin D is a vitamin at all or rather a hormone. The scientific arguments can seem baffling unless you are well versed in science – which I’m not. So, before going any further, here is an idiot’s guide to vitamin D (designed, by me, for people like me!).
It seems that vitamin D is undeniably a vitamin, i.e. an organic substance present in natural foods that is essential to normal metabolism and, if depleted, may cause deficiency diseases. But it also acts like a hormone, i.e. “a substance formed in one organ but transported in the blood to another organ and capable of altering the functional activity of that target organ.”
There are two types of vitamin D: D2, which is what doctors used to prescribe for children with Rickets, and D3 (or “cholecalciferol”), which is what you find in most over-the-counter supplements. Of the two, vitamin D3 is now the vitamin D of choice for supplementation because of its superior therapeutic value. It is also the same type of vitamin D that your body produces in your skin and which is responsible for the pigmentation process after exposure to the UVB light present in sunshine (and, of course, in UVB phototherapy). This is why my doctor prescribed sun exposure when she realised my vitamin D levels were low.
The reason we are so reliant on sunshine for the production of this vitamin is that only small amounts of it are available in the diet. It is worth knowing that D3 (the more therapeutic type) is only found in animal-based foods (especially oily fish, egg yolks and raw milk) so if you follow a vegetarian or vegan diet in your quest for better health and better skin you may be even more prone to D deficiency than those of us who do include these foods in our diet.
To return to the subject of my doctor’s advice, it has been my experience that mainstream medical doctors hardly ever mention the word “vitamin” (and rarely talk about nutritional supplementation) so the fact that vitamin D has made its way into the vocabulary of routine western medicine just goes to highlight the superstar status this vitamin has attained. (In fact, vitamin D even has its own “fan club”: the Vitamin D Council, a California-based non-profit organisation set up to educate people on the importance of sun exposure and vitamin D and their blog is well worth following.)
It seems to me there is still a real lack of joined-up thinking among GPs. The impression I get is that they are generally aware of the health risks of not having enough vitamin D (hence, my doctor mentioned it in general and as an afterthought) but they are not good at identifying deficiency as a potential cause of apparently unrelated illnesses (hence my doctor didn’t make the connection between my long history of vitiligo, CFS and fibromyalgia and my recent borderline-cancerous ovarian cyst – all proven indicators of vitamin D deficiency). I am not blaming my GP for not having the time or the resources to play the diagnostic detective but it does serve as a reminder that our western health system has its blind spots and that some intelligent, in-depth googling in the right places can be a sensible thing to do if you are determined to take responsibility for your own good health.
Having said all of that, vitamin D supplementation is definitely not without its pitfalls. For example, every time I have added separate D supplements to my nutritional regime in the past I have immediately suffered some very unpleasant side effects and, not surprisingly, given up on them again. So, as this is a whole subject in itself, I will leave you with that cliff-hanger and continue with that topic next time :)
My name is Caroline.