Patient discussions

There continues to be numerous association studies supporting the concept that vitamin D has a wide range of health benefits not related to calcium metabolism and bone health. These health benefits include reducing risk for autoimmune disorders, neurocognitive dysfunction, cardiovascular disease, type 2 diabetes, some deadly cancers, and infectious diseases.

For those with deficiency or insufficiency, explain to patients the importance of taking lifelong maintenance doses of vitamin D to prevent recurrence. Advise people to continue taking vitamin D supplementation throughout the year, even during the summer months.

Regarding sensible sun exposure, consider the following points to guide patient discussions; note that advice must be carefully individualised and balanced based on age, skin type, and behaviour, along with awareness of UV index levels:[15][78][149]

  • Sensible sun exposure (always avoiding sun burning) can provide a source of vitamin D without significantly increasing risks of skin damage and skin cancer.

  • The amount of sun exposure required depends on time of day, season, latitude (vitamin D cannot be made in the winter unless you are below a latitude of about 35ºN and above 35ºS), and skin pigment.​

  • Exposure of the arms and legs (with sun protection on the face) for about 5-30 minutes (depends on degree of skin pigmentation, time of day, season, latitude, and age of patient) between 10 a.m. and 3 p.m. twice a week may be sufficient to stimulate an adequate amount of cutaneous vitamin D production to satisfy the body’s requirement.

  • People who choose to expose their skin to strong sunlight to increase their vitamin D status should be aware that prolonged exposure (e.g., leading to burning or tanning) is unlikely to provide additional benefit.

  • There is little evidence to suggest that sunscreen reduces 25-hydroxyvitamin D levels in real-world conditions, suggesting that concerns about vitamin D deficiency should not override recommendations for skin cancer prevention.[150][151][152]​​​​​

  • There are smartphone apps available that can provide advice about sensible sun exposure, give information about how much vitamin D is being made in the skin during current sun exposure, and alert the user when to stop the exposure to prevent sunburn.

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