- People at age 70 gets only 25% of Vitamin D from the sun as at age 20
- Avoiding the sun is a problem
- 75% less flu if high vitamin D level
- Less Vitamin D from the sun and from food
- Vitamin D levels should be over 45 or 50 ng
- 5,000 IU is safe, some need 10,000 IU daily
- Toxic is >250 ng
- Vitamin D is linked to many health problems
- If people had >45 ng of vitamin D there would be 400,000 fewer premature deaths
- The many ways you will feel better with high Vitamin D
- People with Dark Skins get far less Vitamin D from the sun
- Need a test to confirm you have gotten to 45-75 ng
- Need to supplement with Vitamin D3 all year unless you work outdoors
- Be careful of what sunscreens you use
- 51+ Transcripts in VitaminDWiki
People at age 70 gets only 25% of Vitamin D from the sun as at age 20
0:00:00.0 To the average 70-year-old, creates only 25% of the vitamin D that a 20-year-old does. I think it's one of those basic supplements that everybody should get. It makes such a difference.
0:00:08.3 If you're like most Americans, you're probably thinking about taking a vacation this summer and hanging on a beach or swim on a lake or playing outside, and you'll be exposed to a lot of sun and getting a lot of sun exposure. Now, I see patients who take a lot of pretty drastic measures to get sun. They bask for hours by the swimming pool. They slather on high SPF sunscreen. They think it's gonna be protective against the UV rays from the sun. Others are terrified of the sun and stay out of the sun, use parasols and hats and cover their whole bodies and don't go outside during the day. There's gotta be a little balance in the middle, right?
0:00:45.9 So finding safety with sun exposure is important, so you do it right, you don't overdo it. But you need the sun for many reasons because of our hormonal systems, our circadian rhythms, vitamin D which is critical for our health. And I do get why people are a little worried about sun exposure. According to the Environment Working Group or EWG, more than 2 million Americans get skin cancer every year, and half of those who live to 65 get at least once. Now, skin cancers that are basal cell and squamous cells are not fatal. They don't spread. They can be disfiguring. My grandmother had a big one on her scalp, which was terrible. She never wanted get it treated and it was nasty.
0:01:31.2 But basically, the squamous and basal cell cancers that you get on your skin are linked to sun exposure. Melanoma, not so much. And that can occur in non-sun-exposed areas and be a little bit of a different animal. Now, the other thing about sun exposure is particularly on your face, it's gonna cause something called oxidative stress. And that leads to inflammation. And oxidation is kinda like your car rusting or an apple turning brown in the air. But it's really the same thing that happens on your skin. You get wrinkles. So the wrinkling is from the oxidative stress from the sun. You see people who've been in the sun a long time, they get wrinkly, leathery skin, and ladies who wear parasols have this beautiful porcelain skin [chuckle] as they get older.
Avoiding the sun is a problem
0:02:15.0 So your face is something you definitely wanna protect. But also, we're supposed to be out in the sun. And so staying out of the sun or over-relying on sunblock actually can cause issues because vitamin D is critical for mood, for energy, for thyroid function, for cancer protection, for immune function, preventing infections, even COVID. And it's a problem if you don't get enough vitamin D. And the problem is, most of us don't get vitamin D 'cause we don't live and workout outside anymore. Most of us are inside most of the time. And we get deficient in this really important vitamin called vitamin D. And the truth is, that probably 80% of Americans are in deficient or have insufficient levels of vitamin D, levels that don't protect them optimally from things that you wanna have vitamin D protect you from, whether it's osteoporosis or depression or cancer, or to boost your immune system so you don't get things like the flu or COVID.
75% less flu if high vitamin D level
0:03:13.9 I mean, if you have high vitamin D levels, you're reduction in flu is 75%. That's more than the flu vaccine, [chuckle] so it really is a powerful nutrient. It's very safe at the recommended doses. It's easy to take. There's no side effects. It's very cheap and it's such an incredibly important vitamin for optimizing your health in every way, including longevity. So, let's talk about vitamin D a little bit. Now, people think they should be avoiding the sun to not get skin cancer, but vitamin D actually protects you against skin cancer, believe it or not, and reduce the risk of melanoma dramatically and many other cancers, not just skin cancer. It actually reduces overall mortality by 7%. So just having good vitamin D levels reduce the risk of death by 7%.
Less Vitamin D from the sun and from food
0:04:01.0 And vitamin D, we used to get from the sun running around naked hunting-gathering. And also if we were living in colder climates, we would eat fish, wild fish like herring and sardines and mackerel. These fatty small fish have pretty high levels of vitamin D. Also mushrooms; if you're foraging and going for mushrooms, there's a lot of like... Porcini mushrooms have the highest levels of vitamin D. But it's still hard to get enough, [chuckle] and we're not getting these foods anymore. So we saw such a, with the industrial revolution, this incredible advent of rickets and vitamin D deficiency. And it's one of the major areas where we've seen a public health improvement by getting awareness of vitamin D.
Vitamin D levels should be over 45 or 50 ng
0:04:43.9 Now, it's been fortified in milk. Milk doesn't necessarily have vitamin D. It does actually doesn't have vitamin D. It only has vitamin D because it's added in to the milk. So if you think you need milk to get your vitamin D, that's not actually true. You don't get vitamin D from milk only because it's added. Now, most of the problem with vitamin D is that doctors don't understand how to diagnose it. They might even order the wrong test. They don't know the right treatment. They don't know the doses. They don't understand its importance. And they see the reference levels on a lab test, which are typically like 20 nanograms per deciliter. Now, that is ridiculously low. And I think if you look at what's optimal, it should be over 45 or 50. And so many, many people are in this sort of borderline area of less than 20, or 20 to 50, where they do need more vitamin D.
5,000 IU is safe, some need 10,000 IU daily
0:05:33.4 Now, most doctors think, "Oh, you don't have rickets, you don't have a vitamin deficiency, or your number's like 20 or 30, you're fine." And they're actually wrong. And the question is, what's the dose you need to not get rickets? It's probably like 30 units a day. It's not what we need for optimal health. What we need for optimal health might be more like 5000 units a day. Even the government's upper limit is 4000 or 5000 a day is a safe dose. You're not gonna get into trouble with that. And some people are very good at absorbing it, others aren't. Some people need actually up to 10,000 units a day. There was one study where they gave healthy young adults 10,000 units of vitamin D for three months and there was no toxicity from that.
Toxic is >250 ng
0:06:12.6 Now, you can get toxicity if you take a lot more, and it can cause a problem, but it's far lower than we think. And in fact, your level has to be over 250. Even though the reference range on the labs is up to 100, it doesn't really become toxic until about 250. So the real question is, how much should we be taking on a daily basis? And I think they're depending on you and your vitamin D level, your sun exposure. I have a friend who lives on the beach and goes out surfing every day and his vitamin D level is about 45, which is pretty good with no vitamin D supplementation. But I rarely see that unless she's living in Mexico on the beach all the time.
Vitamin D is linked to many health problems
0:06:48.9 But if you aren't, you probably need between 2000 to 5000 units a day of vitamin D. What's really concerning is, when you look at the data, it's 80% of us who are insufficient or deficient. This is either frankly deficient, let's say less than 30, which is now the reference range on most labs, although some still say 20, and those who are between 20 and 50. So I think that's important because vitamin D deficiency is linked with many cancers, to high blood pressure, heart disease, diabetes, depression; we call it Seasonal Affective Disorder or SAD, [chuckle] fibromyalgia. People have muscle aches and pains. These are often from low vitamin D levels. Bone loss, obviously osteoporosis, even autoimmune diseases. Multiple sclerosis is found in much higher levels in northern latitudes and where there's low vitamin D.
If people had >45 ng of vitamin D there would be 400,000 fewer premature deaths
0:07:38.7 So vitamin D is really important for everything, including autoimmune disease. And it's really not hard to do. You really could make a dramatic difference by just getting people's levels of vitamin D up to 45 nanograms per milliliter, and that would literally lead to 400,000 fewer premature deaths a year. That is no joke. There was one study that showed that if your vitamin D levels were low, you were 75% more likely to end up in the hospital or in the ICU from COVID. If your vitamin D levels were over 50 from one big Israeli study, there was no death, like zero. Now, that may be not true if you keep doing the study and it may be a little bit bigger, there may be occasional deaths, but the point is here that vitamin D is highly protective. So I think we probably should have a vitamin D mandate in this country. [laughter]
The many ways you will feel better with high Vitamin D
0:08:29.9 Now, when my patients get their levels up,
- they feel better,
- they have more mood improvements,
- their muscles recover better,
- their thyroid works better,
- their energy is better,
- their whole system works better.
And so it's a really important thing to make sure you get. So how does your body make vitamin D? Now, we obviously never had to take supplements when we were hunting and gathering and evolving 'cause we're outside most of the time. And in fact, 80% to 100% of the vitamin D that we need is created because of exposure to the sun. And when you get a little bit of a sunburn, and we call a minimal erythema dose, which means basically the dose that makes your skin a bit red when you get a sunburn, that might produce between 10,000 to 25,000 units of vitamin D in our bodies, which is great. The problem is, most of us don't get that kind of sun exposure. And a lot of times we use a lot of sunscreen, which is not necessarily bad, well, it depends on which sunscreen you're using, but they block a lot of the benefits of getting vitamin D. So you might be out in the sun but using sunblock and then not getting vitamin D.
People with Dark Skins get far less Vitamin D from the sun
0:09:34.0 Now, if you live in a northern climate, you're for sure not getting enough sun and vitamin D especially in the winter, and you're probably not eating a lot of the porcini mushrooms and mackerel and herring and cod liver oil. [laughter] Also the other problem is, as we get older, our skin does not convert the sun into vitamin D in the way that we did when we were younger. So the average 70-year-old creates only 25% of the vitamin D that a 20-year-old does. Also depending on your skin color, if you have dark skin, if you're African American, you basically will produce far less vitamin D and you need a lot more sun exposure. So most African Americans are very deficient in vitamin D.
Need a test to confirm you have gotten to 45-75 ng
0:10:17.1 I also recommend that everybody supplement. Now, I think it's one of those basic supplements that everybody should get. It make such a difference and you should have a level between 45 to 75, let's say. And the only way to know what that is is to test. You need to test and find out what's going on. And you can guess, but you often will be off. Some people need 2000 units, some people need 5,000, some people need 10,000 units to get their vitamin levels up to the ideal level. And you can do that through your doctor or... I co-founded a company called Function Health. You go to functionhealth.com, you can join the wait list and get testing that actually helps you to get your actual levels, to know what you're doing, to check it over time. And then you may use the code YOUNG4EVER, you can get in and actually get off the wait list. So try that and see how your vitamin D levels are, but it's important to know.
Need to supplement with Vitamin D3 all year unless you work outdoors
0:11:13.4 And often doctors say, "Oh, don't worry, just take the vitamin D," but you really want to know what your levels are. Also, if you want to get sun exposure, the best is 10:00 to 2:00 in obviously the summertime. 10 AM to 2 PM, full body sun exposure for 20 minutes. You can cover your face or put sunblock on your face, but you really want to have full body exposure. It only works in the summer and only works if you live below Atlanta. So [laughter] I recommend taking vitamin D, and probably 2000 to 5000 of vitamin D3. It's important to take vitamin D3, not vitamin D2. Most doctors will prescribe vitamin D2, which is unfortunate, but make sure you get the right vitamin D. And again, it depends on your age, your genetics, where you live, how much time you're in the sun, time of year. But if you're, "Oh, it is summer, I don't need it," but it's actually not true. You need it during the summer unless you're out there all the time. So check your vitamin D levels and find out what's going on.
0:12:11.8 Now, what about protecting yourself from skin cancer? That's important, right? You want to make sure you don't get skin cancer, particularly on your face. So I think if you want to go out in the sun, great. Use sunscreen on your face. If you're worried about getting a sunburn and you're really out there a lot, you can use high SPF sunscreen. But you're gonna get vitamin D from your supplements, so you should be okay. The high SPF, it kind of gives people a false sense of security that you can go out there and just burn up. But you want to be careful. You don't want to do that. You want to make sure you just moderate your sun exposure, avoiding the high ultraviolet radiation exposures that you can get from prolonged sun exposure. So basically use sunscreen. And also, by the way, you want to use sunscreen that doesn't have crap in it, [chuckle] and we'll talk about that in a minute.
Be careful of what sunscreens you use
0:12:58.0 So over-the-counter sunscreens are fine but they're often full of crappy, harmful ingredients. EWG found 80% of the 1700 products they looked at that were sunscreen, had inferior sun protection or had really weird ingredients like oxybenzone or other parabens. I had a woman once who was in my practice and she had super high levels of toxins in her urine from parabens, and she's like a super health nut and I'm like, "What are you doing? What are you exposed to, with plastics or chemicals?" She said, "Oh, well, I use a ton of sunscreen all the time every day." And so she had high levels of these toxic petrochemical plastics in her urine that were coming from the sunscreen. Now, a lot of it wasn't getting out of her body so it wasn't great. Also, you should be worried about sunscreen with vitamin A. If you use vitamin A, it actually can make the skin cancer more likely, so I would be particularly careful of that. But the bottom line is, choose good average low SPF sunscreen. Don't rely on it for total protection. Cover your face mostly, and you'll be able to go out and enjoy the sun.
0:14:06.7 So what are the seven strategies I use to get safe sun exposure? Well, don't be afraid of the sun on your vacation. Don't obviously get overexposed, right? 'Cause getting overexposed doesn't just ruin your vacation, it will give you a sunburn. It can lead to long-term issues with skin damage and skin cancers and more wrinkles which nobody wants. So try to get at least 20 minutes of sun exposure every day, at first thing in the morning ideally, which is the morning sunlight helps trigger your brain to release chemicals and hormones like melatonin. And it kind of resets your circadian rhythms, it helps mood, healthy aging. Use sunscreen but only when you need it and particularly use the safe sunscreens. You can check out Skin Deep which is a database from EWG and it's great. Be proactive about protection. So don't overdo it, right? Try to get shade, umbrella, tree, hat, protective clothing, that's fine.
0:15:04.0 If you [0:15:04.9] ?? don't get skin cancer, which I don't want to get, [laughter] make sure you cover up. Sunglasses are important. You don't actually get, obviously, sunburn in your eyes but you get cataracts from prolonged sun exposure without UV blocking sunglasses, so that's important. Don't get burned. Burning is really bad 'cause that leads to more risk of skin cancer. Choose a [0:15:22.9] ?? skin cancer has optimal to UVA protection. Don't do tanning beds. Get vitamin D which will help reduce your risk of skin cancer. And there's good evidence that sunblock prevents squamous cells but not necessarily basal cells. So make sure you get skin checks. Get your skin checked for cancer on a regular basis every year. Make sure you get a good dermatologist to look at it, and they can get things when they're early and they're really not a problem. You don't die from skin cancer except melanoma which is not necessarily sun-related.
0:15:54.2 Also again, make sure you check the ingredients. You don't want to have parabens, petrochemicals, lead, toxins. They all get absorbed in your skin. Go to the EWG website ewg.org. You can look at the sunscreen guide, the Skin Deep guide. Also stay hydrated. Drinking out caffeine, having alcohol on the beach makes us dehydrated and that can actually just make you feel crappy and not make your vacation fun.
0:16:20.1 So, it's important to make sure that you're getting the adequate vitamin D you need for many reasons we discussed. Two, that you don't want to avoid the sun. You want to get in the sun and for many reasons. Three, try to use good sunblock and use it on your face primarily. And don't overdo it.