The Sun Exposure Dilemma

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The Sun Exposure Dilemma

Yesterday, we asked you about your policy on sun exposure, and got the above-pictured, below-described, set of answers:

  • A little over a third of respondents chose “I recognize the risks, but I think the benefits outweigh them”
  • A quarter of respondents chose “I am a creature of the shadows and I avoid the sun at all costs‍”
  • A little over a fifth of respondents chose “I recognize the benefits, but I think the risks outweigh them”
  • A little under a fifth of respondents chose “I’m a sun-lover! Give me that vitamin D and other benefits!”

All in all, this is perhaps the most even spread of answers we’ve had for Friday mythbuster polls—though the sample size was smaller than it often is.

Of those who added comments, common themes were to mention your local climate, and the importance of sunscreen and/or taking vitamin D supplements.

One subscriber mentioned having lupus and living in Florida, which is a particularly unfortunate combination:

Lupus Foundation | Lupus & UV exposure: What you need to know

Another subscriber wrote:

❝Use a very good sunscreen with a high SPF all the time. Reapply after swimming or as needed! I also wear polarized sunglasses anytime I’m outside.❞

…which are important things to note too, and a lot of people forget!

See also: Who Screens The Sunscreens? (on fearing chemical dangers, vs the protection given)

But, onto today’s science for the topic at hand…

We need to get plenty of sun to get plenty of vitamin D: True or False?

True or False, depending on so many factors—to the point that many people get it wildly wrong in either direction.

Whether we are getting enough vitamin D depends on many circumstances, including:

  • The climate (and depending on latitude, time of year) where we live
  • Our genes, and especially (but not only) our skintone
  • The clothes we wear (or don’t)
  • Our diet (and not just “how much vitamin D do we consume”)
  • Chronic diseases that affect vitamin D metabolism and/or requirements and/or sensitivity to the sun

For a rundown on these factors and more, check out:

Should I be getting my vitamin D levels checked?

Notably, on the topic of whether you should stay in the sun for longer to get more vitamin D…

❝The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed (which could be just a few minutes, in a sunny climate) is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.❞

Source: Dr. Elina Hypponen, professor of Nutritional Epidemiology, and director of the Australian Centre for Precision Health at the University of South Australia Cancer Research Institute.

In contrast, she does also note:

❝During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D.❞

See also: Vitamin D & Calcium: Too Much Of A Good Thing?

We can skip the sun and get our vitamin D from diet/supplements: True or False?

True! However, vitamin D is not the only health benefit of sun exposure.

Not only is sunlight-induced serotonin production important for many things ranging from mood to circadian rhythm (which in turn affects many other aspects of health), but also…

While too much sun can cause skin cancer, too little sun could cause other kinds of cancer:

Benefits of Sunlight: A Bright Spot for Human Health

Additionally, according to new research, the circadian rhythm benefits we mentioned above may also have an impact on type 2 diabetes:

Can catching some rays help you fight off type 2 diabetes?

Which way to jump?

A lot of it depends on who you are, ranging from the factors we mentioned earlier, to even such things as “having many moles” or “having blonde hair”.

This latter item, blonde hair, is a dual thing: it’s a matter of genetic factors that align with being prone to being more sensitive to the sun, as well as being a lesser physical barrier to the sun’s rays than dark hair (that can block some UV rays).

So for example, if two people have comparably gray hair now, but one of them used to have dark hair and the other blonde, there will still be a difference in how they suffer damage, or don’t—and yes, even if their skin is visually of the same approximate skintone.

You probably already know for yourself whether you are more likely to burn or tan in the sun, and the former group are less resistant to the sun’s damage… But the latter group are more likely to spend longer in the sun, and accumulate more damage that way.

If you’d like a very comprehensive downloadable, here are the guidelines issued by the UK’s National Institute for Health and Care Excellence:

NICE Guidelines | Sunlight exposure: risks and benefits

…and skip to “At risk groups”, if you don’t want to read the whole thing; “Skin type” is also an important subsection, which also uses your hair and eye color as indicators.

Writer’s note: genetics are complicated and not everyone will fall neatly into categories, which is why it’s important to know the individual factors.

For example, I am quite light-skinned with slightly graying dark hair and gray-blue eyes, and/but also have an obscure Sámi gene that means my skin makes vitamin D easily, while simultaneously being unusually resistant to burning (I just tan). Basically: built for the midnight sun of the Arctic circle.

And yet! My hobbies include not getting skin cancer, so I tend to still be quite mindful of UV levels in different weathers and times of day, and make choices (schedule, clothing, sunscreen or not) accordingly.

Bottom line:

That big self-perpetuating nuclear explosion in the sky is responsible for many things, good and bad for our health, so be aware of your own risk factors, especially for vitamin D deficiency, and skin cancer.

  • If you have a predisposition to both, that’s unfortunate, but diet and supplementation at least can help with the vitamin D while getting modest amounts of sun at most.
  • Remember that you can only make so much vitamin D at once, so sunbathing for health benefits need only take a few minutes
  • Remember that sunlight is important for our circadian rhythm, which is important for many things.
  • That’s governed by specific photoreceptor cells, though, so we don’t need our skin to be exposed for that; we just need to be able to see sunlight.
  • If you’re going to be out in the sun, and not covered up, sunscreen is your friend, and yes, that goes for clear cold days under the winter sun too.
  • Most phone weather apps these days have a UV index score as part of the data they give. Get used to checking it as often as you’d check for rain.

Stay safe, both ways around!

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  • Lyme Disease At-A-Glance

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Good info as always…was wondering if you have any recommendations for fighting Lyme disease naturally along wDr advice? Dr’s aren’t real keen on alternatives so always interested. Thanks❞

    That depends on whether we’re looking at prevention or cure!

    Prevention:

    • Try not to get bitten by Lyme-disease-carrying ticks. Boots and long socks are your friends. As are long-gauntletted gloves for gardening.
    • If you are in a high-risk area and/or engage in high-risk activities, check your body daily.
      • This is because it usually takes 36–48 hours of being attached for a tick to cause an infection
      • Obviously best if you can get a partner or close friend to help you with this, unless you have mastered some advanced pretzel positions of yoga.
    • Contrary to many folk remedies, the safest way to remove a tick is with tweezers (carefully!).
    • If you find and remove a tick, or otherwise suspect you have developed symptoms, go to your doctor immediately (not next week; today; time really counts for this).

    Cure:

    • No. Sorry. Regretfully, antibiotics are the only known effective treatment.

    However! As with almost any kind of recovery, getting good rest, including good quality sleep, will hasten things. Also sensible is reducing stress if possible, and anything that could worsen inflammation.

    Read: Beyond Supplements: The Real Immune-Boosters!

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  • Dandelion: Time For Evidence On Its Benefits?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In recent decades often considered a weed, now enjoying a resurgence in popularity due its benefits for pollinators, this plant has longer-ago been enjoyed as salad (leaves) or as a drink (roots), and is typically considered to have diuretic and digestion-improving properties. So… Does it?

    Diuretic

    Probably! Because of the ubiquity of anecdotal evidence, this hasn’t been well-studied, but here’s a small (n=17) study that found that it significantly increased urination:

    The diuretic effect in human subjects of an extract of Taraxacum officinale folium over a single day

    You may be thinking, “you usually do better than an n=17 study” and yes we do, but there’s an amazing paucity of human research when it comes to dandelions, as you’ll see:

    Digestion-improving

    There’s a lot of fiber in dandelion greens and roots both, and eating unprocessed or minimally-processed plants is (with obvious exceptions, such as plants that are poisonous) invariably going to improve digestion just by virtue of the fiber content alone.

    As for dandelions, the roots are rich in inulin, a great prebiotic fiber that indeed definitely helps:

    Effect of inulin in the treatment of irritable bowel syndrome with constipation (Review)

    When it comes to studies that are specifically about dandelions, however, we are down to animal studies, such as:

    The effect of Taraxacum officinale on gastric emptying and smooth muscle motility in rodents

    Note that this is not about the fiber; this is about the plant extract (so, no fiber), and how it gets the intestinal muscles to do their thing with more enthusiasm. Of course you, dear reader, are probably not a rodent, we can’t say for sure that this will have this effect in humans. However, generally speaking, what works for mammals works for mammals, so it probably indeed helps.

    For liver health

    More about rats and not humans, but again, it’s promising. Dandelion extract appears to protect the liver, reducing the damage in the event of induced liver failure:

    Protective Effects of Taraxacum officinale L. (Dandelion) Root Extract in Experimental Acute on Chronic Liver Failure

    In other words: the researchers poisoned the rats, and those who took dandelion extract suffered less liver damage than those who didn’t.

    …and more?

    It may help improve blood triglycerides and reduce ischemic stroke risk, but most of this research is still in non-human animals:

    New Perspectives on the Effect of Dandelion, Its Food Products and Other Preparations on the Cardiovascular System and Its Diseases

    And while we’re on the topic of blood, it likely has blood-sugar-lowering effects too; once again (you guessed it), mostly non-human animal studies, though, with some in vitro studies:

    The Physiological Effects of Dandelion (Taraxacum Officinale) in Type 2 Diabetes

    Want to try some?

    We don’t sell it, but if you have a garden, that’s a great place to grow this very easy-to-grow plant without having to worry about pesticides etc.

    Alternatively, if you’d like to buy it in supplement form, here’s an example product on Amazon 😎

    Enjoy!

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  • Unwell Women – by Dr. Elinor Cleghorn

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    For a demographic that makes up a little over half of the world’s population, women are paradoxically marginalized in healthcare. And in other ways too, but this book is about health.

    Dr. Cleghorn had to fight for seven (!) years to get her own lupus condition recognized as such, and continues to have to fight for it to be taken seriously on an ongoing basis. And yet, 95% of the book is not about her and her experiences, but rather, the bigger picture.

    The book is divided into sections, by period in history. From Hippocrates to the modern day, Dr. Cleghorn gives us a well-researched, incredibly well-referenced overview of the marginalization of women’s health. Far from being a dry history book in the early parts though, it’s fascinating and engaging throughout.

    The modern day sections are part shining a light into dark areas, part practical information-and-advice “did you know this happens, and you can do this about it”, and part emphatic call-to-action to demand better.

    Bottom line: this book is in this reviewer’s “top 5 books read this year”, and we highly recommend it to you.

    Click here to check out Unwell Women, and don’t settle!

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  • Just One Heart – by Dr. Jonathan Fisher

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First, what this is not: a book to say eat fiber, go easy on the salt, get some exercise, and so forth.

    What this rather is: a book about the connection between the heart and mind; often written poetically, the simple biological reality is that our emotional state does have a genuine impact on our heart health, and as such, any effort to look after our heart (healthwise) would be incomplete without an effort to look after our heart (emotionally).

    Dr. Fisher talks about the impact of stress and uncertainty, as well as peace and security, on heart health—and then, having sorted emotional states into “heart breakers” and “heart wakers”, he goes about laying out a plan for what is, emotionally and thus also physiologically, good for our heart.

    Chapter by chapter, he walks us through the 7 principles to live by:

    1. Steadiness: how to steady your heart amid chaos
    2. Wisdom: how to develop a wise heart in uncertain times
    3. Openness: how to safely open your heart in a threatening world
    4. Wholeness: how to show up with your whole heart without going to pieces
    5. Courage: how to lead with a courageous heart when fear surrounds you
    6. Lightness: how to live with a light heart in a heavy world
    7. Warmth: how to love with a warm heart when life feels cold

    The style is anything but clinical; it’s well-written, certainly, and definitely informed in part by his medical understanding of the heart, but it’s entirely the raw human element that shines throughout, and that makes the ideas a lot more tangible.

    Bottom line: if you’d like your heart to be healthy (cardiac health) and your heart to be healthy (emotional health), this book is a very worthwhile read.

    Click here to check out Just One Heart, and take care of yours!

    Don’t Forget…

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    Learn to Age Gracefully

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  • The Lupus Solution – by Dr. Tiffany Caplan & Dr. Brent Caplan

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Lupus is not fun, and this book sets out to make it easier.

    Starting off by explaining the basics of autoimmunity and how lupus works, the authors go on the address the triggers of lupus and how to avoid them—which if you’ve been suffering from lupus for a while, you probably know this part already, but it’s as well to give them a look over just in case you missed something.

    The real value of the book though comes in the 8 chapters of the section “Tools & Therapies” which are mostly lifestyle adjustments though there are additionally some pharmaceutical approaches that can also help, and they are explained too. And no, it’s not just “reduce inflammation” (but yes, also that); rather, a whole array of things are examined that often aren’t thought of as related to lupus, but in fact can have a big impact.

    The style is to-the-point and informational, and formatted for ease of reading. It doesn’t convey more hard science than necessary, but it does have a fair bibliography at the back.

    It’s a short book, weighing in at 182 pages. If you want something more comprehensive, check out our review of The Lupus Encyclopedia, which is 848 pages of information-dense text and diagrams.

    Bottom line: if you have lupus and would like fewer symptoms, this book can help you with that quite a bit without getting so technical as the aforementioned encyclopedia.

    Click here to check out The Lupus Solution, and live more comfortably!

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  • What are the most common symptoms of menopause? And which can hormone therapy treat?

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    Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers.

    Adding to the uncertainty, a recent series in the Lancet medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate.

    So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says.

    Remind me, what exactly is menopause?

    Menopause, simply put, is complete loss of female fertility.

    Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause).

    Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months.

    Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder).

    What are the most common symptoms of menopause?

    Our study of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are:

    • hot flushes and night sweats (known as vasomotor symptoms)
    • disturbed sleep
    • musculoskeletal pain
    • decreased sexual function or desire
    • vaginal dryness and irritation
    • mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.

    However, none of these symptoms are menopause-specific, meaning they could have other causes.

    In our study of Australian women, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats.

    But the severity of these symptoms varies greatly. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55.

    So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are similarly affected.

    Woman sits on chair, looking deflated
    You don’t need to have night sweats or hot flushes to be menopausal.
    Maridav/Shutterstock

    Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span.

    The most robust guidelines do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of menopausal hormonal changes.

    The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. Some studies suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) have not been shown to change.

    Who might benefit from hormone therapy?

    The Lancet papers suggest menopause hormone therapy alleviates hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats).

    In contrast, the highest quality clinical guidelines consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy.

    Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency).

    Doctor talks to woman
    You don’t need to experience hot flushes and night sweats to take hormone therapy.
    Monkey Business Images/Shutterstock

    However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”.

    Despite musculoskeletal pain being the most common menopausal symptom in some populations, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied.

    Some guidelines, such as an Australian endorsed guideline, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease.

    What are the risks?

    The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot.

    Oestrogen-only menopause hormone therapy is consistently considered to cause little or no change in breast cancer risk.

    Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, has been associated with a small increase in the risk of breast cancer, although any risk appears to vary according to the type of therapy used, the dose and duration of use.

    Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels prescribed at standard doses

    What if I don’t want hormone therapy?

    If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats.

    In Australia, most of these options are “off-label”, although the new medication fezolinetant has just been approved in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat).

    Unfortunately, most over-the-counter treatments promoted for menopause are either ineffective or unproven. However, cognitive behaviour therapy and hypnosis may provide symptom relief.

    The Australasian Menopause Society has useful menopause fact sheets and a find-a-doctor page. The Practitioner Toolkit for Managing Menopause is also freely available.The Conversation

    Susan Davis, Chair of Women’s Health, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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