Originally published on www.westonaprice.org
We have been brainwashed into believing that the sun is toxic, whereas, in fact, it is life-giving. I am a great fan of sunlight exposure to both the skin and the eyes.
The sun has been a resource for Planet Earth since the beginning of time, and biological organisms evolved with a constant supply of energy they could count on every day with the rising sun. Plants use the energy of sunlight to convert inorganic carbon into organic matter, with the help of chlorophyll.
Why would animals ignore such an obvious energy source? Just as plants need sunlight to grow, sunlight plays an essential role in energizing animals, including humans.
I believe that the mechanism with which we safely exploit the sun's energy is through the oxidation of sulfur to sulfate, with the help of cholesterol. This reaction takes place in the skin--catalyzed by sunlight--and it is vital to our long-term health.
Protective Sunlight
People who live in places with little sun have a statistically higher risk for many chronic conditions, including multiple sclerosis, diabetes, cardiovascular disease, autism, Alzheimer's disease, and age-related macular degeneration.1 On the other hand, a great deal of epidemiological evidence suggests that sunlight exposure protects from many different types of cancer. Ultraviolet (UV) radiation is recommended for treating different skin conditions, including psoriasis, eczema, jaundice, and acne. Sunlight may also be beneficial in healing various autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, and thyroiditis.
Yet chances are that your dermatologist has told you to "stay out of the sun and take a vitamin D supplement every day." For some, this has seemed like good advice because we have been taught to believe that the sun causes skin cancer and that the only reason to get out in the sunlight at all is to boost vitamin D levels through its UV-stimulated synthesis in the skin. Driven by the belief that the benefits of sunlight exposure are mainly due to vitamin D synthesis, the natural conclusion is that vitamin D supplements would achieve the same goal.
The story is not that simple, however. When placebo-controlled studies are conducted on vitamin D supplementation, they usually produce disappointing results. I believe the reason is that sunlight exposure is about a whole lot more than vitamin D synthesis in the skin. In a paper published in 2016, Richard Weller wrote: "A substantial body of evidence shows that sunlight has health benefits and that these are independent of vitamin D and thus cannot be reproduced by oral supplementation."2 Supply through supplements or sunlight exposure.
The Role of Sulfate
Those who are familiar with my research know that I believe that keratinocyte cells in the skin, endothelial cells lining the walls of surface veins, and red blood cells are able to exploit the energy in sunlight by oxidizing hydrogen sulfide to make sulfate.3 In the skin, the sulfate is conjugated with both vitamin D and cholesterol, and this makes these otherwise water-insoluble sulfate molecules water-soluble.
This greatly facilitates their transport in the blood, because they no longer have to be enclosed inside lipid particles like high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Sunlight exposure thus produces cholesterol sulfate as well as vitamin D sulfate, and it is the cholesterol sulfate that offers many of the benefits that are seen epidemiologically in sunny places. In fact, I believe that systemic sulfate deficiency is a key driver behind many chronic diseases that are on the rise in industrialized nations.
The sulfate that is produced in response to sunlight also supplies sulfate to the glycocalyx, the mesh of extracellular matrix glycoproteins that line the walls of all blood vessels. Red blood cells hand off cholesterol sulfate to the endothelial cells as they traverse the capillaries, and both the cholesterol and the sulfate are of vital importance to the endothelial cell's health. The endothelial cells also can incorporate the sulfate they synthesize themselves directly into the glycocalyx.
Sulfate in the glycocalyx helps to maintain the structured water in the exclusion zone, a layer of gelled water that coats the surface of all the blood vessels. Not only does the gel protect the blood vessel wall from oxidative and glycation damage, but it also provides a slick surface for frictionless traversal of the capillary by the red blood cells. And perhaps most importantly, it carries a negative charge, creating a battery that is likely the main source of electricity for the body.
Light--and most especially infrared light--causes the exclusion zone water layer to expand dramatically, by as much as a factor of four.4 The electricity held in the battery grows in direct correspondence. Professor Gerald Pollack from the University of Washington in Seattle has popularized much of this story in his book, Cells, Gels and the Engines of Life.5
Sunscreen Use and Melanoma--Both Rising
Most Americans rely heavily on sunscreen if they are outside for an extended period. Mothers well-trained by conventional messaging slather sunscreen on their children every few hours during a day at the beach, believing that this will keep their children safe from skin cancer, with no downside. Americans strongly believe that they are protecting themselves from skin cancer through this practice, but, in fact, they may be increasing their risk of skin cancer. Sunscreen interferes with the body's natural mechanisms of sun protection, which have been perfected over hundreds of millions of years of life's evolution on Earth.
Given the quantity of advertising urging us to use sunscreen, people probably assume that there is plenty of evidence that sunscreen protects from skin cancer. If this is true, then it is hard to explain why melanoma prevalence has been steadily rising in tandem with the increased use of higher and higher sun-protection-factor (SPF) sunscreens over the past two decades. A study published in 2009, which analyzed almost three hundred million person-years of data over more than a ten-year period, concluded that the rate of skin melanoma increased by 3.1 percent per year from 1992 to 2004 in the United States.6
A population-based study published in 2019--involving twelve thousand four hundred sixty-two cases of head and neck melanoma in the U.S. and Canada from 1995 to 2014--found that this type of cancer had increased by 51 percent over the two decades, with males aged fifteen to thirty-nine years being the population group most strongly affected.7 Meanwhile, the market value of sun protection products increased from $940 million in 2006 to $1.6 billion in 2016.
As far back as 1996, researchers published a paper that investigated whether sunscreen protects from skin cancer. The authors wrote: "Our results support the hypothesis that sunscreens do not protect against melanoma, probably because of their ability to delay or avoid sunburn episodes, which may allow prolonged exposure to unfiltered ultraviolet radiation."8 In other words, sunscreen gives you the illusion that you are safe because you don't feel the pain or experience the skin redness that naturally happens when your body is letting you know it's time to get out of the sun. Your skin is getting damaged by too much UV radiation, but the signal that would stop the exposure is missing.
More Problems with Sunscreen
Worse than this, in my opinion, is that sunscreen disrupts the body's natural mechanism of sun protection: melanin synthesis. Melanin is produced in response to sunlight exposure. Sunscreen protection lasts only while the sunscreen is topically present; melanin, on the other hand, builds up over time and eventually produces a healthy tan with protection that can last for weeks or even months.
The smart way to protect yourself from the potential damage of UV rays is to develop a tan slowly during the spring while the sun is not so intense--this arms you with a defense against the intense summer sun that would otherwise be dangerous. As melanin's powerful antioxidant effects protect you from UV rays, you can still enjoy the many health benefits of visible light and infrared light, far beyond what you would get from a vitamin D supplement.
Sunscreens contain toxic ingredients that cause damage to the skin in ways that might result in sustained disruption of sulfate synthesis.9 Particularly disturbing is the aluminum that is added to emulsify the zinc oxide and titanium dioxide additives (the active ingredients). Aluminum is known to suppress cytochrome P450 enzymes (CYP enzymes). The enzyme that I propose as crucial for sulfate synthesis--endothelial nitric oxide synthase (eNOS)--is an orphan CYP enzyme.
I believe that glyphosate, the active ingredient in the pervasive herbicide Roundup, also disrupts eNOS. It is known to suppress CYP enzymes in the liver in rat studies. Worse than this, glyphosate interferes with the shikimate pathway in the gut microbes, which is essential for producing aromatic amino acids.10 One of these, tyrosine, is a precursor to melanin. Thus, glyphosate likely induces melanin deficiency, which prevents you from developing a healthy tan and, therefore, interferes with natural protective mechanisms against UV damage.
Melanoma, Sun Exposure, and Vitamin D
Instinctively, most people who are diagnosed with skin melanoma make special efforts to avoid the sun following their diagnosis-- which is probably a very bad idea. Remarkably, increased sun exposure, more frequent sunburns, and solar elastosis (evidence of photo-aging in the skin) were all associated with improved survival statistics in a study of five hundred twenty-eight patients diagnosed with cutaneous melanoma.11
It has seemed logical to many that the benefit of increased sun exposure must be due to the rise in vitamin D levels induced by sun exposure. Indeed, vitamin D deficiency at the time of diagnosis is associated with a worse prognosis in melanoma.12 Patients with stage IV melanoma had a twofold worse prognosis if they suffered from vitamin D deficiency at diagnosis. Furthermore, those who began with vitamin D deficiency and whose vitamin D levels either fell or increased by no more than twenty ng/mL had a hazard ratio of 4.68 (meaning a higher risk) compared to patients who were not deficient initially and whose vitamin D increased by more than twenty ng/mL over time.
However, a large placebo-controlled study involving over thirty-six thousand postmenopausal women compared women who were supplemented with four hundred IU of vitamin D3 and one thousand mg of elemental calcium-- every day for seven years--with controls given a placebo.13 Rates of skin melanoma and non-melanoma skin cancer were monitored over the seven-year period. There was no difference in rates of either benign or malignant cancers between the two groups. This strongly suggests that vitamin D is not the reason for improved melanoma survival with sun exposure.
Melanin, Infrared Light, and Skin Cancer
Melanin is able to transform 99.9 percent of absorbed sunlight into heat, and this greatly reduces the skin cancer risk. It also enhances the amount of infrared you can receive from the sun.
A fascinating 2017 study experimented with a novel idea to protect mice from skin cancer.14 It involved a new technique to treat melanoma skin cancer using a transdermal skin patch, infrared light, and melanin. Melanoma tumor cells produce high amounts of melanin. The researchers created a skin patch from ruptured melanoma cells, which they applied to the skin of mice (as a source of melanin). They compared three groups of mice: the controls, mice with only the patch, and mice with the patch plus infrared light exposure.
When the researchers subsequently injected viable melanoma cells into all three groups to induce skin cancer, 100 percent of the control group succumbed to melanoma cancer within a two-month period. Among the mice with the skin patch, only 13 percent survived. Remarkably, mice who received both the infrared light and the patch were all still living after two months, and 87 percent had no tumors. One wonders what would have happened with only infrared and no patch!
Sunlight, Vitamin D Supplements, and Cancer
In the following sections, I will address evidence that sunlight is protective against four distinct diseases and conditions: cancer, heart disease, hypertension, and bone fractures. In each case, studies have shown that vitamin D supplements cannot replace the benefits of sunlight.
As far back as 1980, epidemiological studies showed an inverse geographical relationship between the amount of solar radiation and mortality rates for colon cancer.15 In the forty years since then, numerous studies have shown that a high serum level of vitamin D is associated with reduced cancer risk for diverse types of cancer.
A review paper published in 2018 with one hundred forty references revealed that those with higher serum vitamin D have an improved odds ratio protecting against developing brain, cervical, endometrial, esophageal, ovarian, thyroid, and head and neck cancers as well as gastric adenocarcinoma, hepatocellular carcinoma and lymphoma.16 Moreover, for many types of cancer, those with higher serum vitamin D at the time of cancer diagnosis have statistically improved survival times.
Given all of this evidence for an association between serum vitamin D levels and cancer protection, it seems obvious that vitamin D supplementation should be protective against cancer. However, a large placebo-controlled study published in 2019 by more than fifteen authors obtained disappointing results.17 The study monitored over twenty-five thousand participants over a five-year period, restricting the study population to men over fifty years old and women over fifty-five years old but including participants from various places across the United States. In the group that received vitamin D (two thousand IU per day), supplementation did not lower the incidence of invasive cancer or of cardiovascular events, compared to the placebo group.
Sunlight and Cardiovascular Disease
Researchers have long been aware that there is a direct relationship, epidemiologically, between cardiovascular disease and latitude. People who live at high latitudes have significantly higher rates of heart disease than those nearer the equator.18 Furthermore, more people suffer from heart attacks in the winter than in the summer, in both northern and southern latitudes.19
We have already seen that a large placebo-controlled study did not find any benefit in vitamin D supplementation for heart disease risk. A study based in India is one of the very few controlled studies where the researchers compared vitamin D supplementation to sunlight exposure. The study involved one hundred men who had been diagnosed with severe vitamin D deficiency.20
Half of them were prescribed supplemental vitamin D (one thousand IU/day), and the other half were advised to spend at least twenty minutes out in the sunlight every day at midday. Both groups saw an increase in their serum vitamin D levels, but, remarkably, the two approaches had opposite effects on serum cholesterol. Those exposed to sunlight saw a statistically significant drop in their total cholesterol, and those taking the supplement saw a statistically significant increase.
This makes sense to me because vitamin D supplements are fat-soluble, which means they require the liver to synthesize cholesterol and release LDL particles in order to transport the vitamin D. Sunlight exposure stimulates cholesterol sulfate synthesis in the skin, and the sulfate moiety makes the molecule water-soluble.3
This means that it can be transported in the blood without being packaged up inside an LDL particle. Because it is both water-soluble and fat-soluble, cholesterol sulfate can easily traverse water-based media to be transferred from the membrane of a cell in the skin to the membrane of an HDL particle or a red blood cell, and it can also easily be transferred to a tissue cell in need of additional cholesterol. Hence, sulfation induced by sunlight promotes efficient delivery of cholesterol to the tissues without the need for LDL carrier particles. These ideas are schematized in Figure 1.
Calcitriol is the 1,25(OH)-D3 that is usually produced by CYP enzymes in the kidney, and it is the "active form" of vitamin D. Kidney failure can derail this process, and so patients with kidney failure are often given calcitriol as a supplement. However, a study published in 2006 found it counterproductive for young adults with childhood-onset end-stage renal disease to be given calcitriol supplementation because calcitriol is taken up by cells in the artery wall and leads to increased artery calcification.21
Basically, vitamin D mobilizes calcium but doesn't control where calcium goes. I believe that sulfate deficiency in the vasculature drives a conversion of smooth muscle cells into bone-like cells, and this causes them to actively take up calcium and phosphate. Vitamin D supplements will encourage them to do this faster. Artery calcification is one of the risk factors for cardiovascular disease.
High Blood Pressure
A 2016 paper aptly titled "Sunlight has cardiovascular benefits independently of vitamin D" argued that sunlight is a therapy option for high blood pressure, an important risk factor for cardiovascular disease.2 In the paper, a scatter plot showing mean male population blood pressure versus central latitude for a large number of countries (reproduced here as Figure 2) demonstrated a clear linear relationship. The author argued that the reduction in blood pressure is due to sunlight's stimulation of the release of nitric oxide from the skin.
Nitric oxide (NO) is a well-known "gasotransmitter," a gaseous signaling molecule that has a remarkable ability to induce a relaxation of the artery wall and a resulting drop in blood pressure. Endothelial dysfunction linked to cardiovascular disease is associated with impaired production of NO from arginine by eNOS, and it causes high blood pressure.22 Researchers have recently become aware that the skin is somehow able to release nitric oxide in response to sunlight exposure. Exactly where the NO comes from is somewhat of a mystery because it has become clear that it is not a result of direct synthesis by eNOS.23
A clue comes from the fact that glutathione reacts with nitric oxide to produce S-nitroso glutathione (GSNO), which I believe serves as a temporary storage form of NO. Almost miraculously, visible light (green, blue, and purple) can catalyze the release of NO from glutathione.24 Not only does this cause a relaxation of the blood vessels, but it also frees up glutathione to react with hydrogen sulfide gas to produce sulfate.
FIGURE 1. Schematic of the differences between sunlight exposure and vitamin D supplements. Cholesterol sulfate and vitamin D sulfate, synthesized in the skin following sunlight exposure, can be transported freely in the blood, rather than requiring carrier lipid particles like LDL.
As illustrated in Figure 3, glutathione reacts with reduced sulfur to form glutathione persulfide (GSSH), and this can catalyze the oxidation of the extra sulfur atom to sulfur dioxide in the presence of superoxide. eNOS binds to flavins that respond to visible light by releasing electrons that convert oxygen to superoxide. The sulfur dioxide produced by eNOS is then oxidized to sulfate by sulfite oxidase. What this means is that the visible light in sunlight is crucial both for the release of NO from the skin and the synthesis of sulfate in the skin--and both of these results are crucial aspects of the beneficial effects of sunlight exposure.
Note that eNOS is a "moonlighting" enzyme. As described at length in a paper I published with colleagues in 2015,25 eNOS is able to switch between two synthesized products: nitric oxide and sulfur dioxide, depending on electromagnetic signaling that it receives from the circulating red blood cells.
These results might prompt medical professionals to advise people in higher latitudes to take a vitamin D supplement. However, as we now can guess, a large study on vitamin D supplements and hip fractures gave disappointing results.26 The study involved women over seventy years old who had at least one self-reported risk factor for hip fracture (low body weight, previous fracture, maternal history of hip fracture, smoking or poor health in general).27
The intervention involved daily oral supplementation with one thousand mg of calcium and eight hundred IU of vitamin D3. However, to reduce the risk of vitaminosis D, the study excluded women who took calcium supplements, as well as women with a history of bladder or kidney stones, renal failure, or hypercalcemia. Despite the near-ideal experimental setup, after a median follow-up period of twenty-five months, there was no significant difference between fractures in the treatment group compared to the control group.
Another three-year study compared three different doses of vitamin D--four hundred IU/day, four thousand IU/day, and ten thousand IU/day--specifically looking at bone density. Surprisingly, those on the highest dosage had a statistically significantly worse outcome in terms of bone mineral density.28 I would argue that systemic sulfate deficiency drives calcium into the arteries, leaching it from the bones-- and excessive vitamin D increases the rate at which this happens.
Sunlight and the Eyes
Sunglass marketing ads have trained us to wear sunglasses whenever we go outside, ostensibly to protect our eyes from damaging UV rays. However, melanin--which gives your eyes their blue, hazel, green, or brown color--already protects them from UV rays. In fact, the human eye has evolved to deal naturally with sun exposure through antioxidant protection by melanin, as well as other antioxidant-defense systems based on glutathione and the enzyme superoxide dismutase (SOD). I believe it is crucial to get adequate sunlight exposure to the eyes, not just for the sake of eye health but also because critical nuclei in the brain stem make good use of light that enters through the eyes.
FIGURE 2. Population blood pressure (BP) correlates with latitude. Each point represents a country. Male systolic population BP is plotted against the latitude of the geographical midpoint of each country. BP values are from 1980 MRC-HPA data. See Weller, 2016 for details.2
The Pineal Gland and Sleep Disorders
The pineal gland sits behind the eyes, and it can easily receive light that enters through the eyes. It plays an important role in circadian rhythms and promotes restful sleep by synthesizing large amounts of melatonin as the light fades in the evening. The melatonin is conjugated with sulfate and shipped out into the cerebrospinal fluid at night. In a paper published together with Wendy Morley, I have argued that melatonin supplies sulfate to the neurons in the brain at night and that this supports activities during sleep to break down and recycle cellular debris.29
During the daytime, a sulfotransferase enzyme is sharply upregulated in the pineal gland, and it increases the amount of sulfate in the glycosaminoglycans (GAGs) in the intercellular spaces of the pineal gland.30 From this, we can infer that sunlight catalyzes sulfate synthesis in the pineal gland, and, indeed the cells there express eNOS. The sulfate built up by day can be extracted from the matrix and conjugated to melatonin in the evening to maintain the brain's supply of this critical nutrient.
The Substantia Nigra and Parkinson's Disease
Parkinson's disease (PD) is a relatively common progressive neurological disease manifested as a movement disorder, associated with tremors, stiffness, and slowed movement. It is caused by a loss of neurons in the substantia nigra ("black substance"), a dark structure in the midbrain where dopamine is synthesized. The dark color is due to the substantial production of neuromelanin, a close relative to the skin-tanning agent, melanin. Depigmentation of the substantia nigra due to loss of neuromelanin is a hallmark feature of PD.31
Studies that have measured serum vitamin D levels have found significant differences in PD patients versus controls. One study that compared one hundred eighty-six PD patients with non-PD controls revealed that the PD patients had significantly lower bone density as well as significantly lower serum vitamin D levels compared to controls.32 Another study, based in China, compared two hundred one newly-diagnosed PD patients with one hundred ninety-nine controls and likewise found that low serum vitamin D was linked to Parkinson's.33
The Chinese study also used a questionnaire to determine whether the study participants took vitamin D supplements and how much sun exposure they obtained. The frequency of Parkinson's disease in the group in the highest quartile of sun exposure was only half of the rate for those in the lowest quartile. Interestingly, serum vitamin D levels were highly correlated with the degree of sun exposure but not with vitamin D supplementation.
One way in which sun exposure may be beneficial in Parkinson's is through exposure to the eyes! Bright-light therapy has been shown to benefit PD patients, improving sleep, mood, and also motor function.34 A remarkable study on rats was able to measure the amount of light reaching the mesencephalon (the midbrain, which houses the substantia nigra) when light was shone on the eyes.35
They observed a sharp peak at around seven hundred ten nanometers, which is in the range of infrared light. It is likely that sunlight stimulates the synthesis of neuromelanin, just as it stimulates the synthesis of melanin in the skin. The neuromelanin then likely protects the dopaminergic neurons from oxidative damage by mopping up free radicals.
FIGURE 3. Pathways catalyzed by visible light lead to the synthesis of sulfate and the release of nitric oxide from the skin, lowering blood pressure.
Gerald Pollack's research on structured "exclusion zone" water has shown that infrared light is very effective in growing the exclusion zone size by as much as a factor of four. This will increase the mobilization of electrons (electricity) needed to oxidize oxygen and ultimately form sulfate, assisted by eNOS and sulfite oxidase. The sulfate is of direct benefit to form dopamine sulfate--the water-soluble form of dopamine that is easily transported and delivered to dopamine receptors. This story has parallels to the story regarding cholesterol sulfate in the skin.
Summary
Sunlight has been an important source of energy for Planet Earth since its inception. Plants have learned how to use the energy in sunlight to create organic matter, and I believe that animals have exploited sunlight as a source of energy for movement and for cognition.
Sulfate synthesis in the skin is a powerful way to capture the sun's energy (see Figure 4). Sulfate's diverse roles in the body are essential for good health, particularly for maintaining a healthy vasculature, an electrical supply to the body, and an efficient delivery system for sulfate-conjugated biologically active molecules--such as cholesterol, vitamin D, dopamine, and melatonin.
Sunlight also offers natural protection from the harsh summer sun through the production of melatonin in the skin. Vitamin D supplements, on the other hand, send the tissues a false signal that cholesterol sulfate is plentiful. Sun exposure is important not just to the skin but also to the eyes, and, perhaps more crucially, to the structures in the brain stem behind the eyes that control circadian rhythms (pineal gland) and movement (substantia nigra).
When I tell people that I worship the sun, they often respond with something like, "Yes, I am aware of all the myriad health benefits of vitamin D." Then I have to explain that, no, it is not about vitamin D. It is about something vastly more important. Researchers are frustrated because they see that high serum vitamin D is associated with many health benefits, yet when they conduct placebo-controlled studies on vitamin D supplements, they consistently yield discouraging results. And when those diagnosed with skin cancer become intent on avoiding the sun, they worsen their prognosis.
FIGURE 4. Schematic of differences between vitamin D supply through supplements or through sunlight exposure.
Besides sunlight exposure, some foods naturally provide vitamin D and cholesterol sulfate, and these can be very important for people living in northern latitudes. I suspect that eating lots of seal blubber (an excellent source of both vitamin D and cholesterol sulfate) helped the Eskimos get by. Other sources are raw milk and butter from grass-fed cows, organic lard, and wild-caught fatty fish like salmon and cod liver oil. However, foods artificially supplemented with vitamin D won't do the trick because they don't normally contain cholesterol sulfate. It's also important to eat only certified organic foods to minimize exposure to glyphosate and toxic chemicals that disrupt the body's ability to utilize sunlight appropriately.
There are other simple measures you can take. One that I recommend is simply taking a bath with half a cup of Epsom salts and the water temperature set as high as you can comfortably stand. The sulfate in the Epsom salts will penetrate your skin, with the heat working synergistically to increase exclusion zone water. An infrared sauna is another possibility, although there may be some issues with electromagnetic field (EMF) exposure.
One of the very best things that you can do to maintain good health is to walk barefoot in the water along the ocean shore on a sandy beach on a sunny day. The sand and water assure good grounding, providing the negative charge that is so important to mobilize electrons to fuel the structured water in the exclusion zone lining all the blood vessels. In addition, the ocean air is enriched in hydrogen sulfide gas that can easily penetrate the skin.
If you don't live near the ocean, walking barefoot in the grass is also beneficial. Even in winter when the sun's rays are not so intense, the infrared light is still nearly as strong as in the summer. And even in cold weather, winter sunlight shining on your face and hands is health-promoting. Sunlight energizes the electrons in the exclusion zone to induce the synthesis of sulfate from sulfide, which in turn, maintains the exclusion zone in a natural feedback loop. This is the electrical supply to the body, and sunlight is its primary source.
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