Posts Tagged ‘dermatology vs. endocrinology’

…With Sun Phobia

December 30, 2009

blue soapbox  Want to raise eyebrows?  Try telling people you sunbathe.

What with fear of skin cancer, the compromised ozone layer, and the premature wrinkling caused by too much exposure, sunbathing has fallen so far out of favor in the last few decades that you might as well admit you chain-smoke unfiltered Camels.

I’m naturally pale, like Woody Allen, who put it this way: “I don’t tan.  I don’t burn.  I stroke.”  I’ve always avoided the sun, especially since I’ve had to get little pre-cancerous bumps removed from my hands and face.

But then I found out that like many Americans, I was low on vitamin D, which in my case had led to the soft-bone condition known as osteomalacia, or rickets.   Meanwhile, chronic inflammation had caused me to need a total hip replacement fairly young, and left me with a limited ability to do the weight-bearing exercise that helps protect bones over time.  Maybe my slide into osteopenia and osteoporosis was inevitable, but no way did the D deficit help.

After my hip replacement, the surgeon told me my bones were shockingly mushy, but—get this—didn’t say anything about my needing therapeutic D.  Um, I guess he’d never heard of rickets?  Just a well-regarded bone guy, after all, and this was way back in 1994.

D functions more like a hormone than like a vitamin, and contrary to myth, you may not get enough from drinking milk and walking a block to mail a letter.  Vitamin D deficiency puts you at higher risk for certain cancers, multiple sclerosis, hypertension, and various autoimmune diseases including Type I diabetes.  Serious stuff.  It’s not surprising that sun phobia is promoted by a more than one billion-dollar sun protection industry, but dermatologists?  They’re doctors, right?

At my endocrinologist’s recommendation, I not only pop therapeutic doses of D twice daily, but also make a point of having brief sun sessions without sunscreen (covering up my already-overexposed face and hands with hat and sun gloves).  No one seems to know for sure whether ingesting D in pill form is as good as manufacturing it yourself via sun exposure, so I’m covering all my bases.

I’ve explained my situation to my dermatologist, who checks me every six months and has given me the green light on sunbathing.  She figures that since I’ve never had a sunning habit before, the skin I’m exposing has heretofore been largely undamaged, and that my bone health is the major issue.  And the fact is, the most deadly forms of skin cancer generally either appear in non-sun-exposed areas (e.g., between the toes), or result from severe sunburns in childhood (i.e., the damage is already done).

Random thought: are the dermatologists, endocrinologists and orthopedists planning to collaborate on this issue any time soon?

As for me, my D levels are now good, my immune system seems stronger than ever, and I’m preserving what bone I’ve got.  Sunbathing feels great, too.

Oh, and did I mention I’ve got a tan for the first time in my life?  Medicinal purposes only, you understand.

Published in Piedmont Post August 19, 2009