Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes

• Published in: Journal of the American Academy of Dermatology Vol. 62; no. 6; pp. 929.e1 - 929.e9
• Main Authors: Terushkin, Vitaly, BS, Bender, Anna, MD, Psaty, Estee L., BA, Engelsen, Ola, PhD, Wang, Steven Q., MD, Halpern, Allan C., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.06.2010; Elsevier
• Subjects: Administration, Oral; Biological and medical sciences; Boston; Cholecalciferol - blood; Computer Simulation; Dermatology; Dietary Supplements; Florida; Humans; Medical sciences; oral supplementation; Radiation Dosage; Seasons; Skin - metabolism; Skin Pigmentation; Sunlight; ultraviolet irradiation; Ultraviolet Rays; Vitamin D - administration & dosage; Vitamin D - biosynthesis; vitamin D synthesis; Florida; Boston; UV; oral supplementation; EST; ultraviolet irradiation; Eastern Standard Time; IARC; International Agency for Research on Cancer; MED; vitamin D synthesis; BSA; standard vitamin D dose; SDD; ultraviolet; minimal erythema dose; body surface area; Vitamin D; Dermatology; Comparative study; Oral administration
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2009.07.028

Background The relationship between oral vitamin D supplementation and cutaneous photosynthesis is not well understood. Objective We sought to provide estimates of the equivalency of vitamin D production from natural sun exposure versus oral supplementation. Methods Using the FastRT simulation tool, we determined sun exposure times needed to achieve serum vitamin D3 concentrations equivalent to 400 or 1000 IU vitamin D for individuals of various Fitzpatrick skin types living in Miami, FL, and Boston, MA, during the months of January, April, July, and October. Results Peak ultraviolet B irradiation for vitamin D synthesis occurs around 12 pm Eastern Standard Time (EST). In Boston, MA, from April to October at 12 pm EST an individual with type III skin, with 25.5% of the body surface area exposed, would need to spend 3 to 8 minutes in the sun to synthesize 400 IU of vitamin D. It is difficult to synthesize vitamin D during the winter in Boston, MA. For all study months in Miami, FL, an individual with type III skin would need to spend 3 to 6 minutes at 12 pm EST to synthesize 400 IU. Vitamin D synthesis occurs faster in individuals with lighter Fitzpatrick skin types. The duration to attain 1000 IU of vitamin D is longer in all scenarios. Limitations Results of the computer model are only approximations. In addition, calculations were made based on the assumption that ¼ of 1 minimal erythema dose directed at ¼ body surface area is equal to 1000 IU of oral vitamin D. Conclusions Although it may be tempting to recommend intentional sun exposure based on our findings, it is difficult, if not impossible to titrate one's exposure. There are well-known detrimental side effects of ultraviolet irradiation. Therefore, oral supplementation remains the safest way for increasing vitamin D status.