Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health.

This week we’re going to talk about something that’s very important as we head into the middle of May and the summer months: The Sun!

It’s been a cold and rainy spring thus far, but I think that’s over and we’re going to have a lot more sunshine. 


The Pros and Cons of Sunshine 


There’s a lot of misconceptions about getting sun and getting a tan, which is why we need to talk about getting sunburned and the pros and cons of sun exposure. 

As you probably suspect, the pros far outweigh the cons. 

  • We’ve been somewhat misled on this and have become scared to get out in the sun!
  • We’ve been slathering on chemical laden sunscreen all over our bodies, which probably has a worse effect than getting a tan!
  • We don’t want you to get burned, but we do want you to get some sun every day that you can. 


Two Types of Ultraviolet Rays From The Sun: UVA and UVB


UVA is 95% of the rays. 

UVB is 5% of the rays. 

Think of UVB as the one that causes sun burns and definitely can cause skin cancer. It can cause skin cancer directly because its actions directly damage the skin. 

UVA rays can also cause skin cancer and certainly aging of the skin. It does this more indirectly by changing your DNA. How this happens is the molecules that it produces (think of oxygen free radicals) and the damage they and UVB rays do, cause damage to the collagen in your skin. 

So there’s no doubt that too much sun can cause premature aging, wrinkling, and even skin cancers if you get burned. 

They both do damage to your collagen by different methods. 

They also can cause cataracts, maybe even activations of certain immunosuppressive diseases, and possibly some reactivation of latent viruses in your system. 


The Sun and Skin Cancer 


There are three main types of skin cancer: 

  • Basal Cell Carcinoma 
  • Squamous Cell Carcinoma 
  • Melanoma 

I myself have had a couple: one basal and two squamous cells taken off by my surgeon brother. Fortunately, I have not had any melanomas yet. 

As we age there’s no doubt that our skin is more susceptible to at least the basal. 

We talk a lot about melanomas because they can metastasize and kill you.  

The thing about melanomas is that a lot of them are found in areas that are not even exposed to the sun.

So how do you explain that? 

If you do the research, melanomas are more of a genetically determined thing based on how many nevus you have (another word for mole). 

Nevus are a flat, dark, place on your skin… akin to a freckle but usually darker. 

It turns out that melanomas are about 30 times more related to the amount of nevus you have on your body than the amount of sun exposure you’ve had. 

There’s no doubt that the sun can cause melanomas though. 

These familial types of nevus that you have on your skin are why you should screen your skin for the amount of moles you have and how they appear. 

When you have a lot of what’s called dysplastic nevus on your skin, you’re a lot more at risk for developing melanomas than you are by getting sun. 

I want you to remember that point. 

The most common type of cancer in the world is probably skin cancer. The most common form of skin cancers are the basal cell, which does not metastasize ( or very rarely can erode locally). 

Squamous cells are more likely to spread, but rarely do they metastasize.  

Most of us, if we’ve been in the sun long enough and live long enough, will have a few skin cancers which are pretty easily treatable. We treat them everyday in our offices. 


Benefits of the Sun 


It increases your Vitamin D levels. 

When the sun hits your skin it transforms into the active form of vitamin D which has so many benefits. 

It turns out that the main function of Vitamin D is to maintain your calcium and phosphorus levels to support most metabolic functions, neuromuscular transmission, and of course bone mineralization. 

Vitamin D is a hormone.  One of the most potent hormones in your body. 

At Performance Medicine, over half of what we do is concerned with hormones, the most important hormone being Vitamin D. 

Back in the early 1900’s low Vitamin D levels caused Rickets in kids. When they discovered that it was low Vitamin D that was causing Rickets, it virtually disappeared. 

Adult osteoporosis and osteopenia are both also caused by low Vitamin D. 

Note: As an adult over the age of 40, you should take your Vitamin D with K. Remember Vitamin K helps the Vitamin D bring the calcium into your bones, and not your arteries. You do not want calcified arteries and joints. 


Vitamin D Absorption


There are big differences in the way people absorb Vitamin D. 

This would explain why people with darker skin have lower Vitamin D levels, for example. 

This is an evolutionary thing. Think about living up north, where you don’t get much sun and there are more incidences of all kinds of diseases. 

Those people with lighter skin, or pale people, need more Vitamin D. So this adaptive response enables them to get Vitamin D a lot quicker through sunlight than people with darker skin.

So if you have darker skin (Latino, Black, etc.) you definitely need more Vitamin D supplementation than a pale person would. 

We also find that obese people don’t absorb Vitamin D very well, and certainly elderly people. Elderly people’s thin skin can’t manufacture enough Vitamin D which is why they are getting osteoporosis.

Everybody harps on the sun causing skin cancers, but think about the cancers that the sun prevents:  Breast cancer, Ovarian cancer, Colon cancer, Pancreatic cancer, Prostate cancer, and Lymphoma.  This is because the sun increases your Vitamin D levels! 

These cancers are much more frequent in higher latitudes where the Vitamin D levels are a lot less. You don’t get as much sun.  

This is also true of other non cancerous diseases like MS, Rheumatoid Arthritis, high blood pressure, Metabolic Syndrome, and even Type 1 Diabetes. 

Several studies have shown that kids who have enough Vitamin D have a lesser chance of developing Type 1 Diabetes.

Research shows that kids who receive at least 2,000 units of Vitamin D starting from age one are 80% less likely to develop Type 1 Diabetes. 

Vitamin D is very important in preventing Type 1 Diabetes, which is a lifelong illness. 

Kids with low Vitamin D levels are at four times the risk of developing Type 1 Diabetes, and also Type 2 Diabetes. 

Think about Type 2 Diabetes and metabolic syndrome. They are all increased with low levels of Vitamin D. 

And we’ve already talked about low Vitamin D levels and COVID. 

Nine out of 10 patients in the hospital with COVID had low Vitamin D levels. It should be shouted from the rooftops: Take vitamin D!

It’s been known for decades that Vitamin D protects against viruses and bacteria. 

It’s incredible the benefits the sun will give you. 

Look at the viruses like influenza. Do you know why it’s more common in the winter? 

It’s because you don’t get enough Vitamin D in the winter.

You need sunshine. 


Sunshine and Mood 


This brings me to mood and pain levels. 

The sun helps your mood because of the hormone melatonin. If you get a lot of sun, it makes your melatonin work better at night and you sleep better. 

Note: Serotonin is the melatonin precursor. Melatonin comes from serotonin, the “feel good” neurotransmitter. 

Most of these antidepressants increase your serotonin. So think about that. 

The sun by UV rays also increases your endorphins, and your endorphins are just your natural opiates. So it’s going to help pain as well!




Should you lather sunscreen all over your body? Should you put it on your babies and kids? 

Maybe (If it’s a good sunscreen). 

It’s really important the type of sunscreen you use. 

I’ll start with a few you definitely should NOT USE. 

Don’t use the spray form (aerosolized form) of sunscreens. Those are terrible. They can get in your lungs and they don’t cover you well enough. 

Avoid fragrances and parabens (PABA). You’ll definitely want to avoid the worst one, which is oxybenzone. 

It’s a well known endocrine disruptor. 

If you use sunscreen, it should have some form of Zinc in it. Zinc is natural and it doesn’t hurt you. You can use Zinc Oxide and there’s another one called Titanium Dioxide. This is in most mineral based safe sunscreens. 

Titanium dioxide is a natural mineral, but you certainly don’t want to inhale it. That’s one reason you shouldn’t use an aerosolized form of a sunscreen with that in it. 

I like the sunscreens that have other things in them too, like aloe and some moisturizers. 

There’s a couple that we have in office. One is Glytone and the other is SkinCeuticals. 

I think these sunscreens work best when paired with a Vitamin C serum. 

So if you’re out in the sun for prolonged periods of time, you probably do need a little bit of sunscreen to avoid a burn and the free radical damage that prolonged sunshine can give you. 

You’ll also need to reapply it every couple hours. 

Remember to drink a lot of water when you’re out in the sun. 

I’m not against all sunscreens!  Believe me, you don’t want to get sunburned because it definitely can cause skin cancer and can age your skin prematurely.

To wrap this Note up, don’t be afraid to get out in the sun, especially during the high noon hours. Just try to avoid getting burned. Don’t overdo the sunscreen. Certainly use the natural sunscreens. Read what’s in it. And avoid using the sprays!  

Hope this is helpful heading into the summer months!