Regular use of Vitamin D supplement is associated with fewer melanoma cases

https://pubmed.ncbi.nlm.nih.gov/36580363/

by bookofjoe • 3 years ago

159 99 3 years ago

pubmed.ncbi.nlm.nih.gov

accrual• 3 years ago

Nice to see more benefits of Vitamin D. Highly recommend the supplement for tech workers who spend a lot of time indoors. I take 125mcg/5000IU a day when I wake up and it's subtle, but I just feel a little better with it. Sports Research is a good brand (not affiliated).

Nothing better than getting some real sun though, especially in the morning.

cheald3• 3 years ago

A lot of people in the first world are heavily deficient in vitamin D, and deficiency is linked to a whole host of health issues and vulnerabilities. It's dirt cheap and essentially completely safe below toxicity levels (which are quite difficult to hit - I take 10,000 IU daily, and even with that my bloodwork shows me in the lower quartile of the normal range).

Its metabolite is a steroidal hormone, so it's pretty obvious why it would be beneficial for anti-inflammatory purposes, but it also modulates some key cardiovascular gene expression, too.

globular-toast3• 3 years ago

That seems like far too much, especially if you ever go outside. In the UK doctors recommend no more than 1,000 IU/day during the winter months. Any more than that is only if you are actually deficient. It seems really hard to get clear answers on it, though. People taking 10x the recommended dose of something seems strange. It makes me think it's being stored somewhere that isn't your blood. It's fat-soluble after all. Why on earth would you take so much anyway?

lambdaba• 3 years ago

I second the Sports Research brand it's my favorite based on their obvious careful choice of fillers.

Anyway, yes the full spectrum of the sun provides much more, not only UV for vitamin D but the red/infrared part of the spectrum which is great for cellular energy.

kstrauser3• 3 years ago

Also, ask your doctor to get yours tested! A couple years ago, my D was on the low end (31.7ng/mL; 30-100 is normal). I've been taking 5000IU of D3 since then, and a lab last month had me at 59.1. That seems to be about the perfect dose for me, and it's dirt cheap.

lowmagnet3• 3 years ago

I just take D3 50K a week, what a doctor once recommended when I was tested and found almost with something like 6 ng/dL of D in my system.

BTW, did they tell you to back off or cut your dose? at 59 ng/mL you're in the danger zone.

docflabby• 3 years ago

People who avoid the sun more likely to take vitamin D supplements?

jasonsb• 3 years ago

This is the most plausible reason.

experimenting2• 3 years ago

The most plausible reason is that the scientific peer-reviewed result is correct, not the tiring "correlation does not imply causatian" commenter on HN who at most skimmed the paper.

2009: > Epidemiological data show an inverse relationship between vitamin D levels and breast cancer incidence. In addition, there is a well-documented association between vitamin D intake and the risk of breast cancer. Low vitamin D intake has also been indicated in colorectal carcinogenesis. A vitamin D deficiency has also been documented in patients with prostate cancer, ovarian cancer, as well as multiple myeloma. Larger randomized clinical trials should be undertaken in humans to establish the role of vitamin D supplementation in the prevention of these cancers.

ericmcer• 3 years ago

Yeah… doctors recommend supplementing vitamin D if you don’t get much sun. This almost feels comedic.

cj• 3 years ago

Did the study not control for confounding factors?

lowmagnet3• 3 years ago

Doctors recommend supplementing vitamin D if you have a measured deficiency. Most people naturally settle to 20 ng/mL or higher, and just incidental exposure, or eating certain foods can help you either absorb or synthesize it.

There are also people, like me, who no matter what, we can't make as much vitamin D for whatever cluster of genetic factors causes that. Some of us are always tired unless we take 50,000 IU of D3 a week.

reader5000• 3 years ago

People who avoid the sun are less likely to care about health overall and therefore less likely to take vitD supplements?

jmckib• 3 years ago

I don’t have access to the full paper, but I would expect that they at least tried to control for sun exposure.

In general, if you can think of an obvious confounding factor in about five seconds, then it’s a safe assumption that professional researchers thought of it too.

Gimpei• 3 years ago

They probably have, but that doesn’t mean they have the necessary data to actually address the confounds. Often there is a trade off between what is most provable and what is most novel. Publishing incentives being what they are, novel invariably wins.

surfpel• 3 years ago

safe assumption that professional researchers thought of it too

Research should be able to stand up to scrutiny. The scientific process depends on it.

Given the ongoing reproducibility crisis and plethora of garbage research coming out of academia, I’m not assuming anything about any research I see.

Calavar• 3 years ago

In general, if you can think of an obvious confounding factor in about five seconds, then it’s a safe assumption that professional researchers thought of it too.

I work in academic medicine. I read a lot of papers. This is not at all a given in my experience, except maybe in the tippy top journals (Nature, NEJM). When in doubt, read the paper, see if they mention the confounder you thought of.

kixiQu• 3 years ago

Or, at least, a safer assumption: it's worth checking to see what they said about it before publicly speculating.

And indeed, it seems they did survey for sun exposure and include it in their analysis, and they caveat a lot of their references to other work in their introduction noting where other studies didn't.

https://www.naturalhealthresearch.org/wp-content/uploads/202...

mlinhares3• 3 years ago

The study is based on a couple hundred people in a city in Finland, they could at least have tried to collect data on people closer to the tropics to hedge a bit. I doubt this has any validity ignoring such a basic confounding factor like living in a place that does have a lot of sun exposure.

andreareina• 3 years ago

Accounting for confounders is hard. Otherwise randomised controlled studies wouldn't be needed, and we'd not have taken this long to walk back the consensus that red meat causes cancer.

Gibbon1• 3 years ago

Tweedledee: People with less sun exposure both intentional or unintentional may supplement more.

Tweedledum: Low Vitamin D weakens your immune system. Having a weakened immune system increases your odds of skin cancer.

krona• 3 years ago

I think just as likely is the general problem of people who take supplements being generally more conscientious and less likely to engage in risky behaviours (e.g. wearing sunscreen in summer)

DoesntMatter22• 3 years ago

Or they are supplementing because they don't get much sun to begin with

nemo44x• 3 years ago

Yeah my immediate thought too. Give 2500 rabid tanners vitamin D and let’s look at skin cancer rates in 10 years vs the population of rabid tanners.

rayrey• 3 years ago

I assume the rabies will get them first

beowulfey• 3 years ago

Here is the description how they measured the impact of sun exposure to the results:

The exposure of skin to UV radiation was clarified with different questions. The self-estimated lifetime exposure was studied with the following question ‘How often have you exposed yourself to sunlight during your lifetime?’ The answer options were (1) ‘seldom’, (2) ‘occasionally’, (3) ‘often’, or (4) ‘very often’. The sunburn history was studied with the following question: how often has your skin been burned due to sunlight during your lifetime? The answer options were (1) ‘seldom’, (2) ‘occasionally’, or (3) ‘often’. The answer options for the question of ‘Main environment in working history’ were (1) ‘outdoor’, (2) ‘indoor’, or (2) ‘variably both’.

They saw approximately the same distribution of sun exposure across the different test groups, it looks like.

itake• 3 years ago

I wish they asked exact rates and timelines. Like living in Florida, getting a bad burn only once per year might be considered seldom. But if you lived in Alaska, I’m sure that would be qualify as often.

psychphysic• 3 years ago

Conversely, those people who refuse to ever cover up "cause you need vitamin D".

mlinhares3• 3 years ago

Or people that frequently supplement vitamin D live in places where there isn’t much sun hence the supplements.

kwhitefoot• 3 years ago

So do people who live in high latitudes where there is very little sun in the winter and it is too cold anyway to reveal enough skin.

gp• 3 years ago

Unfortunately I cannot get full article access, but from the abstract it sounds like they did not control for actual sun exposure.

It would seem to me that those who self medicate with vitamin D are those who know they do not get sufficient sun exposure, and would necessarily also be those at reduced risk of melanoma.

mistrial92• 3 years ago

I was told recently that US Doctors have lost their license over this topic; no idea if that is true.

experimenting2• 3 years ago

For a long time, the Mayo Clinic claimed vitamin D supplementation to combat SARS infections had no scientific proof and was possibly dangerous.

If such an authoritative source claims pseudo science and danger, your annecdote could very well be true.

lowmagnet3• 3 years ago

Low vitamin D reduces correct responses by the immune system, and contributes to autoimmune disorders and results in higher possibility of infection.

kstrauser3• 3 years ago

No. My memory of the news stories were that some doctors preached it as a miracle preventative/cure, which let to patients neglecting other more effective preventatives because they thought they were safe from getting sick.

I think any doctor would tell you to take supplements if your lab tests showed that you're low. There's nothing controversial in that advice.

mistrial92• 3 years ago

source: recently retired US Registered Nurse

JumpCrisscross3• 3 years ago

A retired nurse passed you a rumour about a license revocal, a publicly-documented process. Instead of asking for evidence, you repeated the rumour and then tossed in a CYA disclaimer.

resoluteteeth• 3 years ago

I doubt it. Michael F. Holick is probably the biggest vitamin d proponent and he has gained notoriety for having received a lot of money from companies making vitamin d supplements, as well as having done some wild stuff, such as defending abusive parents in court on the theory that children's broken bones are a result of vitamin d deficiency:

In one case of a child who had suffered broken bones in which Holick defended the accused parent, the child later went on to suffer severe brain injury, for which the parent has been indicted.

as well as this interesting theory:

Holick has speculated that the dinosaurs may have died of rickets and osteomalacia caused by a lack of vitamin D in reduced sunlight

https://en.wikipedia.org/wiki/Michael_F._Holick

and the only repercussion he has faced was the place he works not allowing him to treat children anymore.

If he hasn't had his medical license revoked I doubt any doctor simply recommending vitamin d would have theirs revoked.

anonuser123456• 3 years ago

My wife’s OBGYN endorses homeopathy. You have to kill someone or question covid vaccines to lose your license in this country.

fsh• 3 years ago

I can only read the abstract, but this doesn't look very solid at all. It's a self-reported non-randomized study, and an absurdly large number of participants has had some type of skin cancer (184 out of 276). This makes the results extremely susceptible to selection bias.

fatfingerd• 3 years ago

I think by "at risk" they mean they are doing an intentional selection bias on probable skin conditions and it really isn't meant for conclusions..

bravoetch• 3 years ago

Vitamin D is also readily available in food. You can get plenty by eating brown portabella mushrooms. I often read sunshine vs supplements discussed, and rarely food sources.

gochi• 3 years ago

Vitamin D isn't in high enough sources in foods. Not unless you're eating a ~cup of them a day or in the days you aren't taking the supplement. This is important because the study went into differences between "occasional" and "regular" vitamin D supplement users.

Mushrooms are very good for many other reasons and should be a staple in most weekly diets.

thenerdhead3• 3 years ago

I see research on essential vitamins all the time on HN. It really makes you think. There's cohorts who will debunk the studies based on methodology or glaring flaws. There's cohorts who will provide anecdotal evidence in support. There's even cohorts who will bring up a history lesson/"conspiracy" we all forgot about.

It really makes you wonder about essential vitamins though. There's so many of these types of studies that continue to show benefits of getting the right amount of vitamin D, but there's equally enough noise to tell you that you don't need it.

But for countries like America, experts continue to weigh in that we don't get enough essential vitamins and minerals through our diets, so wouldn't it just be common sense that many people are deficient and therefore should supplement?

Wasn't this the entire controversy of Pauling for example when he pushed Vitamin C? That the RDA amounts are not enough and should be highly personalized?

https://www.ncbi.nlm.nih.gov/books/NBK56068/table/summarytab... (Recommendations)

https://www.nature.com/articles/s41430-020-0558-y (Deficiency Worldwide)

mandmandam3• 3 years ago

I think it's absolutely bonkers - it really blows me away - that we have such debate on the effects of single molecules, studied for untold millions of human hours.

And yet many people think we can improve on nature; tinkering and toying with vastly more complex machinery and life, that we barely understand.

We are still discovering entire structures in the human body, ffs, yet are seemingly happy to allow vast monocultures of corporate and for-profit GM crops; 'trusting the science'.

The lies are as thin as our topsoil's gonna be soon. I love the idea of scientific progress, and understanding things, but this attitute of 'trust the men in white coats with everything even though we don't understand Vitamin C or D all that well' is truly mind-boggling.

*: I assume the people down-voting this think I'm talking smack on science - read again. I'm talking about scientism, and hubris, and appeals to authority. Which if you were paying any attention whatsoever the last 3 years you ought to know are big problems right now.

JumpCrisscross3• 3 years ago

we have such debate on the effects of single molecules

Most complex systems have simple limiters, almost by definition of the latter. You don’t need to solve fluid dynamics and combustion physics to understand that more air through a carburettor causes an internal combustion engine to run faster.

hn_throwaway_995• 3 years ago

Two points:

experts continue to weigh in that we don't get enough essential vitamins and minerals through our diets

First, would be better to list some specifics rather than "experts say". But even if so, saying that people don't get enough of some micronutrient X from food, it doesn't necessarily follow that supplementation with pills will lead to better health (except in some specific and extreme circumstances that rarely affect people these days, e.g. scurvy).

Second, this was not the entire controversy around Pauling's vitamin C fantasy. His recommended doses were orders of magnitude larger than recommended amounts - it wasn't just about being "more personalized". Nevermind that Pauling's vitamin C theories have been thoroughly disproven.

thenerdhead3• 3 years ago

1. No, because the specifics change every week. One week you're deficient in fiber, the next Vitamin D. Look to the mainstream news or online articles for this ridiculousness.

2. Maybe consider looking at modern research. https://www.cancer.gov/research/key-initiatives/ras/ras-cent...

Nevermind that Pauling's vitamin C theories have been thoroughly disproven.

Nothing in science is proven. Only re-evaluated.

oarfish• 3 years ago

One issue with supplementation is the food matrix effect - Yes, Vitamin deficiencies are associated with all kinds of badness, but just supplementing this one nutrient doesn't address the underlying problem and often doesn't improve clinical outcomes. Rather, the deficiency is an indicator of poor health satus and to be fixed by adjusting the dietary pattern.

That's the thing with a lot of vitamin d and c associations anyway.

HPsquared• 3 years ago

Use of vitamin D supplement is also probably correlated with sunscreen use. That is, health-conscious people use both.

sacnoradhq2• 3 years ago

I wouldn't doubt it. I'm in both cohorts. (Family history of malignant melanoma, fair skin, and moles and freckles.)

Most men never use sunscreen, including those who spend a great deal of time outdoors. I seriously doubt that cohort takes vitamin D.

brianmcc• 3 years ago

I don't know; vitamin D supplements may be mostly advised in places where there just isn't enough sun.

In Scotland we get insufficient sunshine to produce natural vitamin D for around 6 months of the year, and there's discussion about whether everyone should be supplementing to the point it's been mooted as an addition to the water supply.

That's relevant because nobody uses sun screen during those months. I wouldn't expect any kind of correlation through sheer lack of use.

zaptheimpaler• 3 years ago

Like most nutrition/diet studies it's entirely correlational. Equally likely that people who take Vitamin D also just take better care of their health in other ways like just using sunscreen. Maybe it is true but it's so hard to draw any conclusion from a study like this.

scubadude• 3 years ago

People saying recent sunscreen use is a confounding variable may not be aware that the major cause of melanoma is childhood sun over-exposure.

boringuser2• 3 years ago

These studies have no value.

There is basically no legitimate insight on things in medicine that kind of work (you need very stringent measures for lack of bias, huge varied cohorts, lots of studies, major controls, etc.) so, to this day, most studies on supplements/vitamins are low quality and highly inconclusive.

Things that have a huge effect are much easier to study, but that type of fruit is mostly picked by pharmaceutical companies and patented.

After years, many, many, many studies, billions of dollars, huge cohorts, lots of analysis, the medical industry can say that vitamin d supplements maybe possibly are helpful for some things but could also be harmful, but probably aren't, but also probably don't help unless you're very deficient.

https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-2...

When you start talking about other supplements, you go into crazy-world.

It's not even clear that most pharmaceuticals do anything unless the effect size is very significant.

zingababba• 3 years ago

I've been sunbathing consistently this season for 30-45 minutes 2-4 times a week as weather permits. Recently got my D level tested to see how it has been working and it came back at 51.6ng/mL - pretty happy with this result.

Regular use of Vitamin D supplement is associated with fewer melanoma cases

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