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Tanning Beds and Vitamin D: Trading Cancer for Cancer?
September 20, 2006
What are tanning beds?
Tanning beds were introduced to North America by German scientist Friedrich Wolff in 1978 and began to become popular in the mid-1980s. Since then, tanning beds have been a common way to tan without having to spend hours in the outside sun. From www.wikipedia.com, they give the definition of a tanning bed to be “Also known as a sunbed, a tanning bed is a device emitting ultraviolet radiation (usually UVA, but recently also UVB) used for cosmetic reasons (to induce an artificial tan).” On an average, more than a million Americans use the nations 50,000 tanning facilities (DeNoon, 2006). Sunlight is composed of electromagnetic radiation of varying wavelengths, ranging from the long-wavelength infrared light to the short-wavelength ultraviolet. The ultraviolet light is further subdivided into UVA and the even shorter-wavelength UVB radiation. Although UVB causes sunburns, it is also the component that initiates Vitamin-D production in the skin (Holick, 2004).
Why do we need Vitamin D?
Vitamin D has numerous known benefits, and having a deficiency of this can be very serious. The main function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D also helps in the absorption of calcium, helping to form and maintain strong bones. Without vitamin D, bones can become thin, brittle, soft, or misshapen. Vitamin D has been nicknamed the “sunshine vitamin” because the skin makes it from ultraviolet rays. Sunscreen use blocks these rays, and in turn blocks the prevention of numerous diseases and types of cancer. In several studies, it was found that Vitamin D helped protect against rickets, lymphoma and cancers of the prostate and ironically, the skin. However, the strongest evidence is for colon cancer. Dr. Michael Holick helped make the landmark discovery of how Vitamin D works, and published a book named The UV Advantage, which urges people to get enough sunlight to make Vitamin D. Holick concludes that Vitamin D should be considered essential for overall health and well being (Holick, 2004). Some specific examples of benefits are: improved bone health and prevention of osteoporosis, osetomalacia, and rickets, reduced risk of heart disease, stroke, and breast, colon, and other cancers, alleviations of skin disorders, decreased risk of autoimmune disorders, and enhanced mental health and lessening symptoms of seasonal affective disorder, premenstrual syndrome, and depression (Medscape Staff, 2004).
Why are tanning beds not safe?
The average tanning bulb emits 95% UVA radiation and 5% UVB radiation. The UVA rays are what cause the golden-tan received after tanning whereas overexposure to UVB rays cause sunburn (Women to Women, 1998). The main issue with tanning beds would be the link to causing different types of skin cancer. Melanoma, the cancer that is most commonly caused by UVA and UVB rays, has more than tripled over the past 2 decades, and one person dies of melanoma in this country every hour of every day. Ultraviolet irradiation is the predominant risk fact for the development of both melanoma and nonmelanoma skin cancers (Scarlett, 2003). Below are some examples of what some of the most common types of skin cancers look like.
Are tanning beds a safe source for Vitamin D?
Studies done by Decastro et al. report that exposure of the body’s surface to either direct sunlight or tanning bed radiation was effective in increasing blood concentrations of Vitamin D. In a study done by Decastro et al., the objective was to prove that tanners have a higher vitamin D concentration than those who do not usually use a tanning bed, and the results showed that not only were the levels of Vitamin D higher, but the bone mineral density was also significantly higher, which benefits the skeleton in numerous ways, such as decreasing the risk for osteoporosis. This same experiment showed that the prevalence of Vitamin D deficiency in the winter was significantly lower in the tanners (8%) than the non-tanners (41.5%) From this study, the researchers concluded that a “moderate” use of tanning beds may also provide some medical health benefit. This benefit would be due to the growing amount evidence that having a higher concentration of vitamin D may reduce the risk of colon, breast, and prostate cancers, hypertensions, and autoimmune diseases (Decastro, 2004). Tanning beds seem to be the easier choice because the maximum amount of time spent in a bed is 20 minutes, and these 20 minutes provide more than the necessary amount of Vitamin D needed daily. However, the overall general conclusion is that although we do need more sunlight in our lives to get the necessary Vitamin D, 15-20 minutes of natural sunlight per day is the safest way to do so.
As seen in the above diagram, sunlight, either natural or artificial, produces UVA and UVB rays which in turn produce Vitamin D.
Should I tan instead of taking a Vitamin D supplement?
Although there are many that stress the value of indoor tanning for Vitamin D production and the anticancer benefits are enough to substantiate indoor tanning, many still disagree (DeNoon, 2006). Jody A. Levine, MD, wrote a report that appears in the Journal of the American Academy of Dermatology, and is opposed to the use of tanning beds to obtain Vitamin D. She argues that indoor tanning provides radiation far in excess of what is needed to get enough vitamin D and as a result, too much radiation exposure can actually remove Vitamin D from the body (DeNoon, 2006). The general synopsis is that the best way to get enough Vitamin D is by spending time outside, over both taking a supplement and using a tanning bed. Because there are numerous known risks to tanning beds, natural sunlight is the safer option as of now. If this does prove true, it will be extremely beneficial to people living in areas of the world that do not receive enough sunlight during winter months and become Vitamin D deficient due to this (Fit Commerce Staff, 2006). Also, the emerging research shows that tanning beds may actually help prevent cancer and increase bone density. Supplements can also be taken for Vitamin D; however, most are made with a different form of the Vitamin, D-2, than the needed form, D-3. Also, many of these supplements contain Vitamin A which offsets many of Vitamin D’s benefits (Komo et al., 2005).
Are tanning beds addictive?
It has been proven that exposure to UVB rays can lead to enhanced mental health and lessening symptoms of seasonal affective disorder, premenstrual syndrome, and depression (Holick, 2004). UV radiation is a known human carcinogen, just like tobacco, and emerging evidence is showing that it could be addictive also (Lim, 2005). Daniel DeNoon has begun to study tanning as an addiction and has done several experiments alongside others to prove this theory. For example, in 2005, a study of tanners showed that people who tan a lot are much like people who drink or use drugs too much. That is, too-frequent tanners act a lot like addicts. The researchers looked at frequent tanners, those who tan eight to 15 times a month. Their study shows that frequent tanners get withdrawal symptoms when given naltrexone, a drug that blocks a narcotic-like substance produced in the skin during tanning. Tanning, dermatologists have found, makes the skin give off endorphins, which make the tanner feel good. They are the reason endurance runners report "runner's high,” which could be quite similar to what tanners are feeling after tanning. The author of the 2005 report suggesting that frequent tanning may be a type of substance abuse is Richard Wagner Jr., MD, deputy chairman of dermatology and director of dermatologic surgery at the University of Texas Medical Branch at Galveston. Wagner says the idea came from skin cancer patients who couldn't stop tanning. "Every dermatologist will tell you there are some patients we are concerned about," Wagner reported. "We know ultraviolet light can lead to skin cancer. Yet we all see patients with skin cancer who are always tan. We tell them not to tan on purpose, and some say, 'But doc, I like it too much. It makes me feel relaxed. I know I am getting skin cancer, but I can't stop.'" Although these experiments are showing evidence towards this, there is still a lot of research to be done on this topic of whether or not tanning beds are actually addictive (Chang, 2006).
As seen here, many think of indoor tanning as a time to relax and take a break from daily activities.
Can tanning beds prevent cancer?
Vitamin D deficiency has been associated with increased risks of deadly cancers, cardiovascular disease, multiple sclerosis, rheumatoid arthritis, and type I diabetes. Vitamin D deficiency not only causes an imbalance in calcium homeostasis and bone metabolism, but also has been associated with increased risk of hypertension, autoimmune disorders including type 1 diabetes, and increased risk of dying of breast, colon, ovarian and prostate cancer. It is now recognized that most tissues in the body, including brain, skin, breast, prostate, colon, and others not only have a vitamin D receptor, but also have the enzymatic machinery to convert Vitamin D. Cedric Garland and William Gant did a study that they say shows that UVB rays are associated with the reduced risk of 16 types of cancer through the production of Vitamin D. Garland states that “enhancing vitamin D appears to be the single most important single simple thing that people can do to reduce their risk of cancer, apart from avoiding tobacco and moderation in intake of alcohol” (TanToday Staff, 2006). Dr. Michael Holick made a statement that infuriated the American Academy of Dermatology, when he stated that “morality rates indicate that 150,000 people die of diseases that can be prevented by sensible sun exposure” (Medscape Staff, 2004). Although it looks as though with more experiments and research done, this might be a plausible solution to our Vitamin D deficiency epidemic; the conclusions have not been fully made.
Is it worth the risks?
There are many things to consider when contemplating tanning beds. For example, even if too much sun leads to skin cancer, which is rarely deadly, too little sun may be worse (Komo Staff, 2005). Is trading cancer for cancer the right solution? Dr. Edward Giovannucci from Harvard University has researched this, and now suggest that vitamin D might help prevent 30 deaths for each one caused by cancer (Komo Staff, 2005). Also, Dr. Holick reports that exposure to tanning beds resulted in a “>100% increase in blood concentrations of Vitamin D and was effective in treating hypertension among adult” (Holick, 2004). Studies done show that a MODERATE use of tanning beds may provide medical health benefit, however, larger studies need to be conducted on the potential positive effect of chronic use of tanning beds (TanToday Staff, 2006). Vitamin D supplements that can be bought at any pharmacy are inexpensive, well tolerated, and safe. On the other hand, exposure to UVB radiation in artificial sources, such as tanning beds, carries the risk of increased photoaging and skin cancer. However, in conclusion, because Vitamin D received from artificial tanning and the long-term adverse effects caused by the UVA rays cannot be separated from each other, tanning beds cannot be recommended as a main source of vitamin D (Lim, 2005).
Decastro, S., Tangpricha, V., Turner, A., Spina, C., Chen, T. C., & Holick, M. F. (2004). Tanning is associated with optimal vitamin D status (Serum 25-hydroxy vitamin D concentration) and higher bone mineral density. American Journal of Clinical Nutrition, 80, 1645-1649. Retrieved September 11, 2006, from http://www.ajcn.org/cgi/content/full/80/6/1645
DeNoon, D. (2006, January 20). WebMDHealth- Base Tan: Protection or Radiation Multiplier. Retrieved September 13, 2006, from www.medscape.com/viewarticle/521983
Fit Commerce Staff. (2005, March 9). Fit Commerce.com- Tanning Beds, Sunshine and Vitamin D, Optimum Dosages to Be Determined. Retrieved September 11, 2006, from http://www.fitcommerce.com/
Holick, M. F. (2004). Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. American Journal of Clinical Nutrition, 79, 362-371. Retrieved September 11, 2006, from www.ajcn.org/cgi/content/full/79/3/362
Holick, M. F. (2004). Vitamin D and Health in the 21st Century: Bone and Beyond. American Journal of Clinical Nutrition, 80, 1678S-1688S. Retrieved September 12, 2006, from www.ajcn.org/cgi/content/full/80/6/1678S
Komo Staff And News Services. (2005, May 23). CanLyme-Sunscreen May Lead to More Cancer Deaths as it Blocks Vit. D. Retrieved September 13, 2006, from www.canlyme.com/Vitamin_D_2005.html
Lim, H. W. (2005). Sunlight, tanning booths and vitamin D. Journal of the American Academy of Dermatology, 52, 868-876. Retrieved September 12, 2006, from www.sciencedirect.com
Medscape Medical News Staff (2004, May 19). Medcape Medical News- Experts clash over sun exposure to boost Vitamin D. Retrieved September 13, 2006, from www.medscape.com/viewarticle/537784
Scarlett, W. L. (2003). Ultraviolet Radiation: Sun Exposure, Tanning Beds, and Vitamin D Levels. What You Need to Know and How to Decrease the Risk of Skin Cancer. JAOA, 103, 371-375. Retrieved September 13, 2006, from www.jaoa.com
TanToday Staff. (2006, August 9). Ultraviolet B Radiation Reduces Risk of 16 Types of Cancer. Message posted to www.tantoday.com
Women to Women. (1998). Retrieved September 12, 2006, from www.womentowomen.com/nutritionandweightloss/vitamindandtanningbeds.asp
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