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Effects of vitamin D: Potential impact on West Virginia disease morbidity

Posted on: August 7, 2012   by  John Cannell, MD


I was pleased to see a recent vitamin D paper out of Marshall University in West Virginia, written by Professor Franklin D. Shuler. I started and ran a general practice clinic in the coalfields of West Virginia for almost ten years in the 1980s and can personally verify many of the things Dr. Shuler and colleagues write about.

As we all know, West Virginia is a State full of underground working coalminers. If they work the day shift, they are underground all day, and if they work the “hoot owl’” (night shift), they spend daylight hours getting sleep. Therefore, sunlight is something miners seldom see and thus should have remarkably low vitamin D levels.

Dr Shuler and colleagues lament the fact that a survey of vitamin D levels among miners is lacking; maybe they will do the first one. They point out that the non-bone diseases associated with vitamin D deficiency are either the highest or close to the highest in West Virginia. This includes “fourteen types of cancer, type 1 and 2 diabetes, obesity, cardiovascular disease, hypertension, stroke, and asthma.”

Shuler FD, Lycans D, Salloum E.. Extraskeletal effects of vitamin D: potential impact on WV disease morbidity and mortality. W V Med J. 2012 May-Jun;108(3):56-62

As I was almost fresh out of medical school when I worked in West Virginia, I had no way of knowing how prevalent these West Virginia diseases were in relationship to other States, although I do remember being overwhelmed with them at my clinic, together with Black Lung. I compliment Dr. Shuler for putting two and two together.

He also makes a point I try to emphasize often, saying, “One should emphasize that many of our vital processes have an evolutionary dependence of sun exposure and vitamin D production with over 20 photoactive products produced cutaneously following sun exposure. The ultimate effect of blocking normal cutaneous photoproduct synthesis with sunblock is unknown.”

That is, it may well be dangerous to avoid the sun and just rely on a pill.

Furthermore, he is like me; he’s seen enough vitamin D studies to not just stand still and let people suffer needlessly.

“With the current epidemic of hypovitaminosis D, it is essential to test for and correct this modifiable risk factor by educating patients about appropriate sun exposure, proper nutrition, availability and proper usage of vitamin D supplements.”

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