Are tanning beds an efficient way to increase your Vitamin D intake?

        Chloe Booth

March 30, 2010

 

As people are cautioned, on an increasing basis, to be ware of the sun’s harmful rays and to avoid sun exposure as much as they can, Vitamin D deficiencies have been on the rise. What to do about this? True, you can start eating food that are rich in Vitamin D (unfortunately, there are few) or start taking dietary supplements. However there is another alternative that is beginning to gain more credit for reversing Vitamin D deficiency: the use of indoor tanning beds. Tanning beds are taboo and most people do not think that there is anything to be gained, health-wise, by making use of them. Recent research has begun to claim otherwise. At the same time, there is a common consensus that tanning beds greatly increase one’s risk for skin cancer. Now you must weigh the pros and cons and decide for yourself whether you think the Vitamin D you can get from tanning beds outweighs your risks of developing skin cancer.

 

       

Vitamin D is a vitamin that is not commonly found in many foods, may be fortified in other foods and can be taken as a dietary supplement. The human body can produce for itself Vitamin D when an individual’s skin is exposed to ultraviolet rays (either from the sun or tanning lamps). The rays trigger Vitamin D synthesis. (Deluca, 1998)1 Vitamin D is important to the body because it promotes calcium absorption in the gut and helps sustain serum calcium and phosphate levels to allow for normal mineralization of bones. Without enough Vitamin D, an individual’s bones are susceptible to becoming thing, brittle or misshapen.   One can become Vitamin D deficient in several different ways: when an individual simply has a lower intake of foods rich in Vitamin D or don’t take Vitamin D supplements, if an individual does not expose themselves to sunlight enough, if kidneys cannot convert Vitamin D to the active form that the body can use or if the digestive tract can adequately absorb enough Vitamin D. The two most prevalent diseases that are associated with Vitamin D deficiency are rickets and osteomalacia. (Wharton 2003)2 Children who are Vitamin D deficient can develop rickets and this disease causes a failure of bone tissue to properly develop, which results in soft bones and bone deformities. Vitamin D deficiencies in adults can lead to osteomalacia, which is characterized by weakened muscles and bones.(Jones, 2008)3 

 

In a survey, conducted in 2003 by the American Academy of Dermatology, of over 10,000 young people between the ages of 12-18 from all 50 states, approximately 10% of the people surveyed said they had used a tanning bed in the previous year. As one would probably expect, women were more likely to make use of tanning beds then men were.4 Women are more likely to use tanning beds as they tend to be the more vain of the two sexes and want that golden-bronzed looked.

“On an average day in the US, more than one million people spend time in a tanning salon. It is a $2billion dollar industry, but only 21states have regulations in place.” (Scarlett,2003)5

 

The most obvious concern about the use of tanning beds, is the correlation between exposure to UV rays from the beds’ lamps and the ever-increasing rate of skin cancers that are appearing.  Elizabeth Carruth, who works in the Department of Psychology at Vanderbilt University, researched several articles on the effects of tanning beds on ones health and she concluded that nearly every research paper that was studied came to the conclusion that indoor tanning’s beds are directly linked to increase risks of skin cancers, specifically malignant melanoma.6 Since UVA rays penetrate deep into the skin, they destroy skin fibers and reduce skin’s elasticity resulting in some women’s worst nightmare: wrinkles and crows feet.

 

Tanning beds can be seen as a gift from God for those who want to be tan all year and they can also be seen as a machine that can/will lowering your life expectancy via cancer. These two sides can be presented as such:

It’s the middle of winter and you can’t make it down to St. Barth’s yet all you want is perfect sun-kissed tan. What do you do? If all you care about is looking darker, then tanning beds are the perfect solution. No expensive cost to get tan, just a modest 1$10-20 dollars per session and you can look like you’ve been sunning yourself on the exotic beaches. Tanning beds offer a relatively cheap way to stay dark year round. UV rays do trigger Vitamin D synthesis in the body, tanning beds can be a great way to increase the amount of Vitamin D you have. If you live somewhere where it is often dark and your skin gets very limited exposure to the UV rays of the sun and hence you find yourself to be Vitamin D deficient, a few trips to the tanning salon can fix this.

Tanning beds are most commonly associated with causing higher incidences of melanoma and other skin cancers. Many ask whether a sunk-kissed glow is work the high risk of tanning that is associated with the increasing rates of skin cancer. Tanning is also related to premature aging, as UV rays penetrate the skin deeply and destroy fibers and cause skin to loose its elasticity, irreversible eye damage, immune suppression (most commonly results form overexposure to UVB rays) and allergic reactions. 7

 

When deciding for one’s self about whether the use of indoor tanning beds is more beneficial then harmful, one must remember to pay close attention to who is telling them what. Websites or journals that have the backing and support of institutions such as the Indoor Tanning Association or Wolff Tanning Beds (one of the largest manufacturers of tanning beds), are probably not going to advertise all the health risks that are associated with their product; they want to advertise the benefits of using their beds. These people just want the public to make use of their product, at whatever cost it the consumer may ever have to pay.

When gathering information from websites or journals that are associated with hospitals, research facilities, such as NIH, and others, one can assume that this information and statistics are reliable; they come from multiple studies, from multiple different institutions. Doctors and researchers publish this information in order to better inform the public so that the public can make an informed decision about their health and what precautions they must take in order to maintain their health.

It’s a pretty simple relation to understand: Whom would you believe to tell you the facts about the dangers of smoking? The CEO of Marlboro or a doctor at a reputable hospital?

 

 

      Since sun exposure is an appropriate way to help maintain sufficient levels of Vitamin D, one may start to think that people, who take to heart all the warnings about avoiding too much sun and decide to “hibernate”, may in fact become Vitamin D deficient. This is indeed a valid concern. A review article found in the Journal of the American Osteopathic Association states that, “It has become a valid concern as Vitamin D deficiency has become an epidemic in adults older than 50… Exposure to sunlight is considered to be the most important source of Vitamin D for humans.”(Scarlett)8 As people fret about their skin’s exposure to sun and decide to try and avoid it all cost, they are in fact doing their body a dis-service by not allowing themselves to be exposed to the most important source of Vitamin D.

 

        An article in the British newspaper the Telegraph, printed an article (Grey,Aug. 2009) with the headline, “Sun exposure cancer warnings 'lead to Vitamin D deficiencies’”. Dr Veronique Bataille, who led a study that monitored the Vitamin D levels in 1,414 white women in the UK and compared this to their skin type, the number of “sun-based holidays” the too, the number of times they used tanning bed and the number of times they have burnt, was quoted as saying, “There has been so much effort put into telling people about the damaging effects of ultraviolet light from sunshine, many now take extreme measures to ensure they don't get exposure… We don't want to say that sunbathing is healthy as there is clearly a risk, but people do need a bit of sunshine to stay healthy.”9

 

                  Most people associate over-exposure to sun or the use of indoor tanning beds with increased risks of skin cancer. However, it is mainly a fact that most people repeat without any true background knowledge as to whether the two are actually correlated. The FDA published an article in November 2009, for the general public, that explains the risks associated with tanning and cancer. “Exposure to UV radiation—whether from the sun or from artificial sources such as sunlamps used in tanning beds—increases the risk of developing skin cancer, according to the National Cancer Institute (NCI). Melanoma, the deadliest form of skin cancer, is linked to getting severe sunburns, especially at a young age. In July 2009, the International Agency for Research on Cancer (IARC), part of the World Health Organization, concluded that tanning devices that emit UV radiation are more dangerous than previously thought. IARC moved these devices into the highest cancer risk category: “carcinogenic to humans.” 10As cancer develops over a period of time, the IARC suggested banning the use of indoor tanning beds to the public under the age of 18 in the hopes of protecting the youth from increased risk of developing melanoma and any other type of skin cancer later in life. This decision by the IARC came after the review of 19 studies, that took course over 25 years, on the use of indoor tanning beds: “1)an association between indoor tanning and two types of skin cancer: squamous cell carcinoma and melanoma. 2) an association between UV-emitting tanning devices and cancer of the eye (ocular melanoma). 3) both UV-A and UV-B rays causing DNA damage, which can lead to skin cancer in laboratory animals and human. 4)the risk of melanoma of the skin increasing by 75 percent when tanning bed use started before age 35”.10

                  The article also describes the story of Brittany Cicala of Chesapeake Beach, Md, the former Miss Maryland, who began indoor tanning at the age of seventeen, who used indoor tanning beds “4 times a week, and sometimes up to everyday”. At age 20, she developed melanoma. “Cicala estimates that 90% of her UV exposure was in tanning beds during this three year period”.10

                  The following link shows Cicala telling her story:

                  http://www.cosmopolitan.com/celebrity/news/tanning-bed-control-act

A review article, written by Dr. Michael F. Holick, M.D., Ph.D., in the New England Journal of Medicine, suggests that Vitamin D deficiencies can be reversed through the exposure of UVB radiation that comes from indoor tanning beds. “Most tanning beds emit 2-6% ultraviolet B radiation and are a recommended source of vitamin D3 when used in moderation. Tanners had robust levels of 25-hydroxyvitamin D at the end of the winter and higher bone density as compared with non-tanners For patients with fat malabsorption, exposure to a tanning bed for 30 to 50% of the time recommended for tanning (with sunscreen on the face) is an excellent means of treating and preventing vitamin D deficiency”  (Hollick, 2007)11

 

      The American Journal of Clinical Nutrition conducted a study to show that tanning is associated with optimal Vitamin D status, as well as a higher bone mineral density. The background suggests that people who use a tanning bed, that emits UVB rays, are likely to have higher 25-hydroxyvitamin D concentration than people who do not use a tanning bed on a regular basis. The study followed 50 people who used a tanning bed at least once a week and compared their 25-hydroxyvitmain D concentrations to a control group of 106 people. (blood was taken to monitor the 25-hydroxyvitamin D concentrations.) The result of the study showed that the people who used the tanning bed at least once a week had 25-hydroxyvitamin D concentrations that were 90% higher than those of the people in the control group. (P<0.0001, which indicates a high accuracy). The conclusion that was drawn from this study was, in fact, that “the regular use of tanning beds that emit Vitamin D-producing ultraviolet radiation is associated with higher 25-hydroxyvitamin D concentrations and thus may have a benefit for the skeleton.” (Tangpricha et. al, 2004)12

 

      The American Gastroenetrological Association produced a case report about the study of a 57-year old woman who suffered from Crohn’s disease. (This disease maybe be caused by Vitamin D deficiency and often leaves the afflicted with severe skeletal demineralization, secondary hyperparathyroidism, and muscle weakness). She had only 2 feet of small intestine after undergoing 3 bowel resections. She took daily dietary supplements of Vitamin D (400 IU) and “was dependent on total parental nutrition that contained 200 IU of Vitamin D and calcium for a period of 36 months.”13 Despite the supplements, the subject still complained of muscle weakness and bone pain, as well as continuing to demonstrate insufficient levels of Vitamin D. The subject was then “exposed to ultraviolet B radiation in a tanning bed wearing a 1-piece bating suit for 10 minutes, 3 times a week for 6 months at the General Clinical Research Center, Boston University Medical Center.”13  After four weeks of treatment, her blood tests showed that exposure to the UVB had increased her Vitamin D levels25-hydrocyvitamin D levels by 357%. After 6 weeks of treatments, the subject was able to maintain a normal range of 25-hydroxyvitamin D levels and no longer complained of muscle weakness or bone soreness. (Koutkia et. al., 2001)13

 

      Although studies conducted by reliable institutions have demonstrated that the use of indoor tanning beds can reverse Vitamin D deficiency, as well as help prevent it, I would not recommend that tanning beds be used to prevent and/or reverse Vitamin D deficiency. I believe that the potential risks for cancer, specifically melanoma, as well as other ailments, outweigh the good that comes from increasing the Vitamin D through the use of indoor tanning beds. Marketers of tanning beds as well as institutions like the Indoor Tanning Association specifically do not address all the potential hazards and health problems that their product causes. One must listen to doctors and researchers, people who are not trying to market a product but are looking out for the well-being of the human race. When listening to credited professionals in the field of medicine, and even more specifically epidemiology, dermatology and the likes, it is obvious to draw the conclusion that tanning beds greatly increase your risk for skin cancer and this risk is much larger than the benefit that comes form them.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sources

 

1)   DeLuca HF, Zierold C. Mechanisms and functions of vitamin D. Nutr Rev 1998;56:S4-10. [PubMed abstract] (nih.gov)

2)   Wharton B, Bishop N. Rickets. Lancet 2003;362:1389-400. (nih.gov)

3)   Jones G. Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr 2008;88:582S-6S. [PubMed abstract])  (nih.gov)

4)   http://www.medi-smart.com/derm-tanning.htm, Teens and Tanning: A Dangerous Combination

5)  Journal of the American osteopathic association, Scarlett, review article, volume 103, no 8, aug 2003)

6)   http://www.vanderbilt.edu/AnS/psychology/health_psychology/Tanning.html

7)   Indoor Tanning Association, http://www.theita.com/indoor/faq.cfm#ans22

8)   Ultraviolet Radiation: Sun Exposure, Tanning Beds, and Vitamin D Levels. What You Need to Know and How to Decrease the Risk of Skin Cancer William L. Scarlett, DO. Journal of American osteopathic association

9)   Richard Grey, Scince Correspondent, august 2009 http://www.telegraph.co.uk/health/healthnews/5995654/Sun-exposure-cancer-warnings-lead-to-Vitamin-D-deficiencies.html

10)           US Food and Drug administration, Indoor Tanning: The Risks of Ultraviolet Rays

11)            Hollick, NEJM, Volume 357; 266-281, July 2007)

12)   The American Journal of Clinical Nutrition, Tanning is associated with optimal vitamin D status (serum 25-hydroxyvitamin D concentration) and higher bone mineral density1–3.Vin Tangpricha, Adrian Turner, Catherine Spina, Sheila Decastro, Tai C Chen, and Michael F Holick, American Journal of Clinical Nutrition, Vol. 80, No. 6, 1645-1649, December 2004 )

13)   AGA, journal of gastroenterology, volume 121, issue 6, December 2001, Treatment of Vitamin D Deficiency Due to Crohn's Disease With Tanning Bed Ultraviolet B Radiation ,POLYXENI KOUTKIA, ZHIREN LU, TAI C. CHEN, and MICHAEL F. HOLICK ,Vitamin D, Skin, and Bone Research Laboratory, Department of Medicine, Endocrinology, Nutrition, and Diabetes Section, Boston University School of Medicine, Boston, Massachusetts)