UVR-Induced Vitamin D:
The Elephant Sitting In The Living Room

by Patricia E. Reykdal & Donald L. Smith

This is the first of a series of articles that will discuss the what, where, when, how and why reasons that vitamin D is so important to the health and welfare of Americans. When we first became interested in the benefits of vitamin D 10 years ago, there was only a small trickle of related articles being published in scientific journals and virtually none in the mainstream media. But what started as small stream of articles about this nutrient five or six years ago, became a torrent of information in the last couple of years. If what we have seen in the past year is any indication of the future, scientific and mainstream articles pointing out the incontrovertible benefits of maintaining optimal blood levels of vitamin D will become a flood of biblical proportions that will “wash away” individuals and organizations standing in the way of the truth.

At some point in the near future, it will become obvious to everyone that the American public needs more sensible, moderate and responsible exposure to UVR (ultraviolet radiation) in order to safely attain and maintain optimal blood levels of vitamin D, and that indoor tanning salons constitute a controlled, consistent, convenient and cost-effective source of vitamin D-effective photons.

Thus, salon owners must become knowledgeable about UVR-induced vitamin D so that they can play a leading educational role in the vitamin D revolution that is just ahead. This series of articles will give salon owners the needed educational tools.

“The elephant sitting in the living room” phrase is an allegory used to describe a situation whereby something important is happening that should be perfectly obvious but for inexplicable reasons is blindly ignored. Ignoring something as evident as an elephant sitting in a living room aptly parallels the way vitamin D experts, the media, regulatory agencies and the American public have ignored the importance of safe and effective UVR-induced vitamin D. It is the responsibility of the indoor tanning industry to educate and inform the American public, the media and regulatory agencies so they will remove their blinders and recognize that UVR-induced vitamin D is the elephant sitting in the living room.

Some of the questions addressed in the new series will include:

• Why is vitamin D is so important for optimal health?
• Why has the public been kept from learning the truth about UVR-induced vitamin D?
• How much vitamin D is necessary for optimal health?
• What are the sources of vitamin D?
• How and why did the mistaken belief originate that five to 10 minutes of sunlight exposure is satisfactory to stimulate optimal vitamin D blood levels?
• How does a tanning device compare to sunlight as a source of UVR-induced vitamin D?
• When will indoor tanning salons be considered part of the solution to help resolve the epidemic of vitamin D mediated diseases instead of part of the problem regarding skin cancer?
• How can indoor tanning salons inform their clients about the importance of vitamin D without running afoul of FDA and FTC?

Not too long ago, vitamin D was only thought to be a beneficial nutrient in bone-related conditions such as rickets and osteoporosis. It’s now known that diverse diseases including cancer, diabetes, multiple sclerosis and coronary heart disease are also vitamin D-mediated. In addition, we know that for every one individual who dies prematurely each year from the adverse effects of overexposure to UVR, there are 100 to 250 individuals who die prematurely each year from the adverse effects of underexposure to UVR. Therefore, it is increasingly clear that the odds favor more, not less, sensible, moderate and responsible exposure to UVR.

Thus, the bottom line is that advocating anything that causes the American public to shun sensible, moderate and responsible UVR exposure, including sun avoidance, inappropriate sunscreen use, banning teenagers from tanning, regulatory inhibitions, etc., is, de facto, advocating increasing the death rate from cancer, diabetes, multiple sclerosis and coronary heart disease. The position advocated by the indoor tanning industry on the other hand is that both overexposure and underexposure to UVR should be avoided. This is the only rational and scientifically valid approach.

There are three primary reasons why UVR-induced vitamin D is the “elephant sitting in the living room”. The first reason (as one speaker at the Toronto Vitamin D Symposium commented) is that if a researcher tried to use UVR to stimulate the production of vitamin D in a study he or she would “bring down the wrath of the dermatology community” upon themselves and their institution. The second reason is that pharmaceutical companies are spending millions and millions of dollars trying to find a vitamin D “analog” that is as safe and effective as UVR-induced vitamin D because the first to do so will make a fortune. The third reason is that the indoor tanning industry is specifically prohibited by the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) from promoting the fact that tanning devices deliver UVR photons that stimulate the production of vitamin D. Since we are prohibited by FDA and FTC from telling the truth about this important subject, the American public is only hearing one side of this important issue.

So why is the dermatology community so adamantly against any and all UVR exposure? The answer to this question brings to mind another “elephant-related” analogy, such as the story about how the six blind men described an elephant. As you will recall, the first blind man felt the side of the elephant and decided it was like a wall; the second felt the tusk and thought it was like a spear; the third felt the trunk and thought it was like a snake; the fourth felt the leg and thought it was like the tree trunk; the fifth felt the ear and thought it was like a fan; and the sixth felt the tail and thought it was like a rope. Obviously, the mistaken descriptions came about because none of the blind men could see the entire elephant.

The primary reason that dermatologists advocate sun avoidance and slathering on of sunscreen every day regardless of the season or time of day, is because they view their patients almost exclusively in terms of skin diseases, especially skin cancer, rather than considering their total health status. [Note: This view brings to mind the medical joke that the more a specialist knows about a specific area of the body, the less they understand about the total health status of the patient.] This “medical myopia” and the fact that dermatologists and sunscreen companies have made a lot of money over the past two decades by scaring the American public about skin cancer are, we believe, the primary reasons why an estimated 40 percent to 50 percent of the American public has sub-optimal blood levels of vitamin D.

So how can the indoor tanning industry help bring about a paradigm change regarding the attitude of the media, regulatory agencies and the American public toward UVR-induced vitamin D? In summary, how do we get them all to notice the elephant sitting in the living room?

Future articles in this series will help salon owners find answers to these important questions and provide information to help them educate and inform their clients about the rationale for viewing sun-beds as a controlled, consistent, convenient and cost-effective source of vitamin D-effective photons.

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