Tag Archives: vitamin D

Post 150: Choice Chronicles of the Chronicle Flask

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From citric to hydrofluoric, acids are an ever-popular topic

I began this blog in 2013, and since then I’ve written at least one post a month. This will be the 150th.

I put love and care into all my posts and, in turn, this blog has been good to me. Although no one’s ever paid me to write it, it has brought me work over the years – many people have asked me to write for them having read things here. But life is busier now than it’s ever been, and it’s time to wind things down. You’ll continue to find my non-fiction here and there, I’ll still be regularly updating my fiction blog, and if you want the latest info, look me up on Twitter. In particular, check out the #272sci hashtag for tiny bits of bite-sized science.

In the meantime, how about a little reminder of some of this blog’s most popular, most important, or just my favourite, posts? Let’s go!

The acid that really does eat through everything (2013)
Turns out, everyone loves acid – this post is one of my all-time most viewed. I guess there’s just something compelling about substances that can dissolve metal, and this one is particular special (and terrifying) for its ability to also dissolve glass and ceramic. (Oh, and sorry about the double spaces after the full stops. It was a long time ago. I know better now.)

Butyric acid, a very smelly molecule (2014)
On the subject of acids, this has been another popular post. I suppose if there’s anything more fun than an acid that eats through the bottle you’re trying to store it in, it’s an acid that smells of Parmesan and vomit. Seriously, it is an interesting one: we’re all familiar with the smell of ethanoic acid (aka acetic acid, found in vinegar), and propanoic acid (propionic acid) merely smells a bit sweaty, but add one more carbon and, hoo boy, you have an utterly revolting stench that some people are so sensitive to they can still detect it weeks, even months, after cleaning.

It’s important to understand what sugar actually is if you want to reduce your intake

Sugar that’s not sugar? (2015)
People talk a lot of nonsense about sugar. A particular pet hate of mine is people calling products sugar-free when they’re nothing of the sort, or implying that the type of sugary ingredient they’ve put in the thing they’re trying to sell you is somehow extra-healthy. If actually reducing your sugar intake is your goal (and it’s not a terrible one), this piece might help.

MMS and CD chemistry – the facts (2016)
This is my simple explainer about MMS (‘miracle’ or ‘master’ mineral solution) and CD (chlorine dioxide). This horrible, nasty fad seems to have faded away in recent years – partly thanks to the fact that even its founder, Jim Humble, admitted it cures nothing – but then again, I have seen CD-MMS linked to pseudoscientific Covid ‘cures’. Let’s hope this post continues to do its job as a useful reference for anyone that needs it.

Absurd alkaline ideas – history, horror and jail time (2017)
Continuing the theme of health, I’ve written several posts about so-called ‘alkaline’ diets, and this isn’t the most popular (that would be Amazing Alkaline Lemons?) but this is the one I wish more people would read. It explains where the whole silly notion came from in the first place. (As does this Twitter thread, slightly more succinctly.)

There really is no need to panic about slime

No need for slime panic: it’s not going to poison anyone (2018)
I’ve yet to meet a child who doesn’t love slime, and every now and then the gooey stuff becomes so popular that we start to see scare stories. So it was in 2018. However, with a few sensible precautions, slime really isn’t dangerous. It’s all explained here.

Let’s speed up the rate at which we recognise our female chemists (2019)
This one was all about the little-known Elizabeth Fulhame. She was the first chemist to describe catalytic reactions – in 1794, when the more famous Berzelius was a mere teenager. Let’s remember her name.

Chemical connections: dexamethasone, hydroxychloroquine and rheumatoid arthritis (2020)
Covid hit us in 2020, and it would prompt more than one post – including this one when dexamethasone had its moment in the spotlight. Probably an unfamiliar drug to most people before this point, dexamethasone was one of the first practical treatments for rheumatoid arthritis in the mid-20th century. Unlike some other much-hyped treatments, we have solid evidence for the effectiveness of this medicine – although it is really only useful for people suffering with very severe symptoms. Still, it’s pretty cool that an old drug turned out to be such a useful tool in a modern pandemic.

There’s chemistry in your skin

Sunshine, skin chemistry, and vitamin D (2020)
To make it a nice, round ten, I’ll sneak in another 2020 post. This one is all about vitamin D. A lot of people are very critical of supplements, and while I understand their position, this particular case is slightly different. If you live in certain parts of the world, you really, really should be considering vitamin D supplementation for at least part of the year, and this post will tell you why.

Brilliant Bee Chemistry! (2021)
This one wasn’t so long ago, but I love it. Bees are fascinating creatures, and if you don’t know what the connection between bees and bananas is, you ought to have a read.

So, this is it, folks – thank you, it’s been fun! Happy New Year!

Content is © Kat Day 2022. You may share or link to anything here, but you must reference this site if you do. You can still support my writing my buying a super-handy Pocket Chemist from Genius Lab Gear using the code FLASK15 at checkout (you’ll get a discount, too!) or by buying me a coffee – just hit this button:
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The Chronicles of the Chronicle Flask: 2020

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It’s officially time to put 2020 in the bin! Hurrah! And that means it’s time for a round-up of everything on this blog from the last twelve months. It’s not all COVID-19 related, I promise…

Mystery purple crystals

January began with a mystery, about some strange, blueish-purple crystals that were found under a sink. What were they? Well, if you missed it, or you’ve just forgotten, the answer is here…

I had no idea at the time, but February was the calm before the storm. I was cheerfully talking about the Pocket Chemist. Have you got one? The post has a discount code, and they’re amazingly useful things. Especially if you’re studying from home…

Everything kicked off in March, and back in those early days everyone was all about the hand-washing. It may not be the burniest or the flashiest, but soap chemistry is some of the oldest chemistry we know. Oh, yes, and wash your hands. Properly.

We were all home learning in April. Or trying to, at least. Lots of chemists started messing about with stuff at home — in particular, @CrocodileChemist (aka Isobel Everest — give her a follow) created some gorgeous art with home-made indicators. I wrote all about an easy version, made with the classic: red cabbage.

Red cabbage indicator with various household substances

May featured pyrotechnics. Well, everything was on fire, so it seemed apt. Also, it was the thirtieth anniversary of the publication of the novel, Good Omens.

It was back to COVID-19 science in June, because everyone was talking about dexamethasone — a well-known, readily available and, crucially, cheap steroid that has been shown to help patients with the most severe symptoms. Want to know more about its history? Check out the post.

By July nothing was over, but we’d definitely all had enough. So it was time to talk about something completely different. What better than a post all about sweet things, to mark national lollipop day?

In August the folks at Genius Lab Gear sent me an awesome set of Science Word Magnets. Do you need a set of these for when you finally make it back to a whiteboard? Check out this post for a discount code…

September was all about skin chemistry

There’s evidence that low vitamin D levels are correlated with worse COVID-19 outcomes and, in the UK, we can’t make it in our skin in the winter months — so September was all about vitamin D. Want to know more? Read all about sunshine and skin chemistry.

It’s Mole Day on the 23rd of October, so I did some ridiculous and, frankly, slightly disgusting calculations. Did you know that if we drained the blood out of every, single human on the planet, we’d only have about half a mole of red blood cells? You do now.

In November I went back to cleaning chemistry. Well, we had all been stuck at home for a while. This time, it was ovens. Why is cleaning ovens such hard work? Why do we use the chemicals we use? I explained all that. Read on!

Annnnd that brings us to December, and the STEM Heroes Colouring Book — a project I’m super proud to be a part of. So, hey, there’s been some good stuff!

Here’s to the end of 2020, and let’s hope that 2021 brings us some good things. It has to, surely? January traditionally brings a health scare, but no one’s doing that in 2021, are they? Are they? I guess we’ll find out soon… lots of love to everyone, stay safe, and stay well!


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Sunshine, skin chemistry, and vitamin D

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The UK is on the same latitude as Northern Canada (Image Source: Wiki Commons)

As I write this it’s the last day of September in the U.K., which means we’re well into meteorological autumn and summer is, at least here, a distant memory. The weather is cooler and the days are getting shorter. Soon, the clocks will go back an hour, and we’ll shift from BST (British Summer Time) to GMT (Greenwich Mean Time).

Seasons in the U.K. are particularly marked because of our northerly latitude. British weather tends to be fairly mild (thanks, Gulf Stream), and it’s easy to forget just how far north we are – but a quick look at a globe makes it clear: London is actually further north than most of the major Canadian cities, while the Polar Bear Provincial Park in Ontario is roughly on the same latitude as Scotland’s capital city, Edinburgh.

Yes, I hear you say, but what on Earth (hoho) does this have to do with chemistry?

Well, a clever little piece of chemistry happens in human skin, and, if you live in the U.K., it’s about to stop. At least, until next spring.

Some clever chemistry happens in human skin.

There’s a substance in your skin called 7-dehydrocholesterol (7-DHC). It is, as the name suggests, something to do with cholesterol (which, despite its bad press, is an essential component of animal cell membranes). In fact, 7-DHC is converted to cholesterol in the body, but it’s also converted to something else.

You will have heard of vitamin D. It helps us to absorb calcium and other minerals, and if children, in particular, don’t get enough it can lead to rickets – which leads to weak bones, bowed legs and stunted growth. Vitamin D deficiency has also been linked to lots of other health problems, including increased risk of certain cancers, heart disease, arthritis and even type one diabetes.

More recently, vitamin D has been linked to COVID-19. It’s estimated that around 80-85% of people who contract COVID-19 experience mild or no symptoms, while the rest develop severe symptoms and, even if they recover, may suffer life-altering after-effects for many months. Early data suggest that patients with low vitamin D levels are much more likely to experience those severe symptoms. There’s a plausible mechanism for this: vitamin D helps to regulate the immune system and, in particular, helps to reduce the production of cytokines.

It’s possible that having inadequate levels of vitamin D may increase your chances of a severe response to COVID-19.

Cytokines are small proteins which are important in cell signalling, but if the body starts to produce too many in response to a virus it can cause something called a cytokine storm, which can lead to organ failure and death.

It’s proposed that having the right levels of vitamin D might help to prevent such cytokine storms, and therefore help to prevent a severe COVID-19 response. This is all early stages, because everyone is still learning about COVID-19, and it may turn out to be correlation without causation, but so far it looks promising.

One thing you many not know is that vitamin D is, technically, misnamed. Vitamins are, by definition, substances which are required in small quantities in the diet, because they can’t be synthesised in the body.

But vitamin D, which is actually a group of fat soluble molecules rather than a single substance, can be synthesised in the body, in our skin. The most important two in the group are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3), sometimes known collectively as calciferol.

Shiitake mushrooms are a good source of vitamin D2.

Vitamin D2 is found in fungi, but it’s cleared more quickly from the body than D3, so needs to be consumed in some form daily. Mushrooms are a good source (especially if they’ve been exposed to UV light), so if you like mushrooms, that’s one way to go. Vitamin D3 is hard to obtain from diet – the only really good source is oily fish, although other foods are fortified – but that’s okay because, most of the time, we don’t need to eat it.

Which brings us back to 7-DHC. It’s found in large quantities in the skin, although exactly how it gets there has been the subject of some debate. It used to be thought it was formed from cholesterol via an enzymatic reaction in the intestine wall and then transported to the skin via the bloodstream. But the trouble with this idea is that the blood would pass through the liver, and 7-DHC would be reconverted to cholesterol, never having a chance to build up in skin. A more robust theory is it’s actually synthesised in the skin in the first place, particularly since higher levels are found in a layer closer to the surface (the stratum spinosum) than in the deeper dermis.

We make vitamin D in our skin when we’re exposed to UVB light from the sun.

Anyway, the important thing is that 7-DHC absorbs UV light, particularly wavelengths between 290 and 320 nm, that is, in the UVB range, sometimes called “intermediate” UV (in contrast with “soft” UVA, and “hard” UVC). When exposed to UVB light, one of the rings in the 7-DHC molecule breaks apart, forming something known pre-D3, that then converts (isomerises) to vitamin D3 in a heat-sensitive process.

In short, we make vitamin D3 in our skin when we’re in the sunshine. Obviously we need to avoid skin damage from UV light, but the process doesn’t take long: 10-15 minutes of midday sunlight three times a week, in the U.K. in the summer, is enough to keep our levels up.

Sun exposure is by far the quickest, and certainly the cheapest, way to get your vitamin D. If you live somewhere where that’s possible.

Here’s the thing, though, if you live in the U.K., for a chunk of the year, it’s just not. I’ve pinched the graph here from my husband, whose work involves solar panels, because it makes a nice visual point.

The amount of sunlight we’re exposed to in the U.K. drops sharply in autumn and winter.

From April – September, there’s plenty of energy available from sunlight. But look at what happens from October – March. The numbers drop drastically. And here’s the thing: it turns out that vitamin D production in human skin only occurs when UV radiation exceeds a certain level. Below this threshold? Well, no photocoversion takes place.

In short: if you live in the U.K. you can’t make vitamin D in your skin for a few months of the year. And those few months are starting… round about now.

The NILU has a web page where you can calculate how much vitamin D you can synthesise in your skin on a given day.

If you want to experiment, there’s a website here, published by the Norwegian Institute for Air Research (NILU), where you can enter various parameters – month, longitude, cloudiness etc – and it will tell you how many hours during a given a day it’s possible to synthesise vitamin D in your skin.

Have a play and you’ll see that, for London, vitamin D synthesis drops off to zero somewhere around the end of November, and doesn’t restart until sometime after the 20th of January. In Edinburgh, the difference is even more marked, running from the first week or so of November to the first week of February.

It’s important to realise that it tails off, too, so during the days either side of these periods there’s only a brief period during midday when you can synthesise vitamin D. And all this assumes a cloudless sky which in this country… is unlikely.

The skin pigment, melanin, absorbs UVB. (Image Source: Wiki Commons)

The situation is worse still if you have darker skin because the skin pigment, melanin, absorbs UVB. On the one hand, this is a good thing, since it protects skin cells from sun-related damage. But it also reduces the ability to synthesise vitamin D. In short, wimpy autumn and winter sunshine just isn’t going to cut it.

Likewise, to state the obvious, anyone who covers their skin (with clothing or sunblock), also won’t be able to synthesise vitamin D in their skin.

Fortunately, there’s a simple answer: supplements. The evidence is fairly solid that vitamin D supplements increase blood serum levels as well as, if not better than, sunshine – which, for the reasons mentioned above, can be difficult to obtain consistently.

Now, as I’ve said many times before, I’m not a medical doctor. However, I’m on fairly safe ground here, because Public Health England do actually recommend everyone take a vitamin D supplement from October to May. That is, from now. Yes, now.

I do need to stress one point here: DO NOT OVERDO IT. There always seems to be someone whose reasoning goes along the lines of, “if one tablet is good, then ten will be even better!” and, no. No. Excessive doses of vitamin D can cause vomiting and digestive problems, and can lead to hypercalcemia which results in weakness, joint pain confusion and other unpleasant symptoms.

If you live in the U.K. you should be taking a vitamin D supplement from October-May.

Public Health England recommend everyone in the U.K. take 10 micrograms per day in autumn and winter. Babies under one year should also be given 8.5–10 micrograms of vitamin D in the form of vitamin drops, unless they’re drinking more than 500 ml of infant formula a day (because that’s already fortified).

Amounts can get a little confusing, because there are different ways to measure vitamin D doses, and in particular you may see IU, or “international units“. However, if you buy a simple D3 supplement, like this one that I picked up at the supermarket, and follow the dose instructions on the label, you won’t go far wrong.

So, should you (and everyone else in your family) be taking a simple vitamin D supplement right around now? If you live in the U.K., or somewhere else very northerly, then yes. Well, unless you’re really keen to eat mushrooms pretty much every day. At worst, it won’t make much difference, and at best, well, there’s a chance it might help you to avoid a really unpleasant time with COVID-19, and that’s got to be a good thing.

But, look, it’s not toilet roll. Don’t go and bulk buy vitamin D, for goodness sake.

Until next time, take care, and stay safe.

If you’re studying chemistry, have you got your Pocket Chemist yet? Why not grab one? It’s a hugely useful tool, and by buying one you’ll be supporting this site – it’s win-win!

Like the Chronicle Flask’s Facebook page for regular updates, or follow @chronicleflask on Twitter. Content is © Kat Day 2020. You may share or link to anything here, but you must reference this site if you do. If you enjoy reading my blog, and especially if you’re using information you’ve found here to write a piece for which you will be paid, please consider buying me a coffee through Ko-fi using the button below.
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Want something non-sciency to distract you from, well, everything? Why not check out my fiction blog: the fiction phial.

The Chronicles of the Chronicle Flask: 2018

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As has become traditional, I’m finishing off this year with a round-up of 2018’s posts. It’s been a good year: a few health scares which turned out to be nothing much to worry about, one which turned out to be a genuine danger, a couple of cool experiments and some spectacular shiny balls. So without further ado, here we go…

Things were a bit hectic at the start of this year (fiction writing was happening) and as a result January was quiet on the blog. But not on the Facebook page, where I posted a couple of general reminders about the silliness of alkaline diets which absolutely exploded, achieving some 4,000 shares and a reach (so Facebook tells me anyway) of over half a million people. Wow. And then I posted a funny thing about laundry symbols which went almost as wild. It’s a strange world.

February featured BPA: an additive in many plastics.

In February I wrote a piece about BPA (Bisphenol A), which was the chemical scare of the day. There’s always one around January/February time. It’s our penance for daring to enjoy Christmas. Anyway, BPA is a chemical in many plastics, and of course plastic waste had become – and remains – a hot topic. BPA is also used in a number of other things, not least the heat sensitive paper used to produce some shopping receipts. It’s not a harmless substance by any means, but it won’t surprise anyone to learn that the risks had, as is usually the case, been massively overstated. In a report, the European Food Safety Authority said that the health concern for BPA is low at their estimated levels of exposure. In other words, unless you’re actually working with it – in which case you should have received safety training – there’s no need to be concerned.

In March I recorded an episode for the A Dash of Science podcast, and I went on to write a post about VARD, which stands for Verify, Author, Reasonableness and Date. It’s my quick and easy way of fact-checking online information – an increasingly important skill these days. Check out the post for more info.

April ended up being all about dairy and vitamin D.

April was all about dairy after a flare-up on Twitter on the topic, and went on to talk about vitamin D. The bottom line is that everyone in the UK should be taking a small vitamin D supplement between about October and March, because northern Europeans simply can’t make vitamin D3 in their skin during these months (well, unless they travel nearer to the equator), and it’s not a nutrient we can easily get from our food. Are you taking yours?

May featured fish tanks, following a widely reported story about a fish-owner who cleaned out his tank and managed to release a deadly toxin that poisoned his entire family. Whoops. It turns that this was, and is, a real risk – so if you keep fish and you’ve never heard of this before, do have a read!

In June I wrote about strawberries, and did a neat experiment to show that strawberries could be used to make pH indicator. Who knew? You do, now! Check it out if you’re looking for some chemistry to amuse yourself over the holidays (I mean, who isn’t?). Did you know you can make indicators from the leaves of Christmas poinsettia plants, too?

Slime turned up again in July. And December. And will probably keep on rearing its slimy head.

July brought a subject which has turned up again recently: slime. I wrote about slime in 2017, too. It’s the gift that keeps on giving. This time it flared up because the consumer magazine and organisation Which? kept promoting research that, they claimed, showed that slime toys contain dangerous levels of borax. It’s all rather questionable, since it’s not really clear which safety guidelines they’re applying and whether they’re appropriate for slime toys. Plus, the limits that I was able to find are migration limits. In other words, it’s not appropriate to measure the total borax content of the slime and declare it dangerous – they should be looking at the amount of borax which is absorbed during normal use. Unless your child is eating slime (don’t let them do that), they’re never going to absorb enough borax to do them any harm. In other words, it’s a storm in a slimepot.

August was all about carbon dioxide, after a heatwave spread across Europe and there was, bizarrely, a carbon dioxide shortage which had an impact on all sorts of things from fizzy drinks to online shopping deliveries. It ended up being a long-ish post which spanned everything from the formation of the Earth, the discovery of carbon dioxide, fertilisers and environmental concerns.

September featured shiny, silver balls.

In September I turned my attention to a chemical reaction which is still to this day used to coat the inside of glass decorations with a thin layer of reflective silver, and has connections with biochemistry, physics and astronomy. Check it out for some pretty pictures of silver balls, and my silver nitrate-stained fingers.

In October I was lucky enough to go on a ‘fungi forage’ and so, naturally, I ended up writing all about mushrooms. Did you know that a certain type of mushroom can be used to make writing ink? Or that some mushrooms change colour when they’re damaged? No? You should go back and read that post, then! (And going back to April for a moment, certain mushrooms are one of the few sources of vitamin D.)

Finally, November ended up being all about water, marking the 235th anniversary of the day that Antoine Lavoisier formally declared water to be a compound. It went into the history of water, how it was proven to have the formula H2O, and I even did an experiment to split water into hydrogen and oxygen in my kitchen – did you know that was possible? It is!

As December neared, the research for my water piece led me to suggest to Andy Brunning of Compound Interest that this year’s Chemistry Advent might feature scientists from the last 24 decades of chemistry, starting in the 1780s (with Lavoisier and Paulze) and moving forward to the current day. This turned out to be a fantastic project, featuring lots of familiar and not quite so-familiar scientists. Do have a look if you didn’t follow along during December.

And that’s it for this year. I hope it’s been a good one for all my readers, and I wish you peace and prosperity in 2019! Suggestions for the traditional January Health Scare, anyone? (Let’s hope it’s not slime again, I’m getting really tired of that one now…)

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Where did our love of dairy come from?

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The popularity of the soya latte seems to be on the rise.

A little while ago botanist James Wong tweeted about the myriad types of plant ‘milk’ that are increasingly being offered in coffee shops, none of which are truly milk (in the biological sense).

This generated a huge response, probably rather larger than he was expecting from an off-hand tweet. Now, I’m not going to get into the ethics of milk production because it’s beyond the scope of this blog (and let’s keep it out of the comments? — kthxbye) but I do want to consider one fairly long thread of responses which ran the gamut from ‘humans are the only species to drink the milk of another animal’ (actually, no) to ‘there’s no benefit to dairy’ (bear with me) and ending with, in essence, ‘dairy is slowly killing us‘ (complicated, but essentially there’s very little evidence of any harm).

Humans have been consuming dairy products for thousands of years.

But wait. If dairy is so terrible for humans, and if there are no advantages to it, why do we consume it at all? Dairy is not a new thing. Humans have been consuming foods made from one type of animal milk or another for 10,000 years, give or take. That’s really quite a long time. More to the point (I don’t want to be accused of appealing to antiquity, after all), keeping animals and milking them is quite resource intensive. You have to feed them, look after them and ensure they don’t wander off or get eaten by predators, not to mention actually milk them on a daily basis. All that takes time, energy and probably currency of some sort. Why would anyone bother, if dairy were truly detrimental to our well-being?

In fact, some cultures don’t bother. The ability to digest lactose (the main sugar in milk) beyond infancy is quite low in some parts of the world, specifically Asia and most of Africa. In those areas dairy is, or at least has been historically, not a significant part of people’s diet.

But it is in European diets. Particularly northern European diets. Northern Europeans are, generally, extremely tolerant of lactose into adulthood and beyond.

Which is interesting because it suggests, if you weren’t suspicious already, that there IS some advantage to consuming dairy. The ability to digest lactose seems to be a genetic trait. And it seems it’s something to do, really quite specifically, with your geographic location.

Which brings us to vitamin D. This vitamin, which is more accurately described as a hormone, is a crucial nutrient for humans. It increases absorption of calcium, magnesium and phosphate, which are all necessary for healthy bones (not to mention lots of other processes in the body). It’s well-known that a lack of vitamin D leads to weakened bones, and specifically causes rickets in children. More recently we’ve come to understand that vitamin D also supports our immune system; deficiency has been meaningfully linked to increased risk of certain viral infections.

What’s the connection between vitamin D and geographic location? Well, humans can make vitamin D in their skin, but we need a bit of help. In particular, and this is where the chemistry comes in, we need ultraviolet light. Specifically, UVB – light with wavelengths between 280 nm to 315 nm. When our skin is exposed to UVB, a substance called 7-dehydrocholesterol (7-DHC to its friends) is converted into previtamin D3, which is then changed by our body heat to vitamin D3, or cholecalciferol – which is the really good stuff. (There’s another form, vitamin D2, but this is slightly less biologically active.) At this point the liver and kidneys take over and activate the chloecalciferol via the magic of enzymes.

We make vitamin D in our skin when we’re exposed to UVB light.

How much UVB you’re exposed to depends on where you live. If you live anywhere near the equator, no problem. You get UVB all year round. Possibly too much, in fact – it’s also linked with skin cancers. But if you live in northerly latitudes (or very southerly), you might have a problem. In the summer months, a few minutes in the sun without sunscreen (literally a few minutes, not hours!) will produce more than enough vitamin D. But people living in UK, for example, get no UVB exposure for 6 months of the year. Icelanders go without for 7, and inhabitants of Tromsø, in Norway, have to get by for a full 8 months. Since we can only store vitamin D in our bodies for something like 2-4 months (I’ve struggled to find a consistent number for this, but everyone seems to agree it’s in this ballpark), that potentially means several months with no vitamin D at all, which could lead to deficiency.

In the winter northern Europeans don’t receive enough UVB light from the sun to produce vitamin D in their skin.

In the winter, northern Europeans simply can’t make vitamin D3 in their skin (and for anyone thinking about sunbeds, that’s a bad idea for several reasons). In 2018, this is easily fixed – you just take a supplement. For example, Public Health England recommends that Brits take a daily dose of 10 mcg (400 IU) of vitamin D in autumn and winter, i.e. between about October and March. It’s worth pointing out at this point that a lot of supplements you can buy contain much more than this, and more isn’t necessarily better. Vitamin D is fat-soluble and so it will build up in the body, potentially reaching toxic levels if you really overdo things. Check your labels.

Oily fish is an excellent source of vitamin D.

But what about a few thousand years ago, before you just could pop to the supermarket and buy a bottle of small tablets? What did northern Europeans do then? The answer is simple: they had to get vitamin D from their food. Even if it’s not particularly well-absorbed, it’s better than nothing.

Of couse it helps if you have access to lots of foods which are sources of vitamin D. Which would be…  fatty fish (tuna, mackerel, salmon, etc) – suddenly that northern European love of herring makes so much more sense – red meat, certain types of liver, egg yolks and, yep, dairy products. Dairy products, in truth, contain relatively low levels of vitamin D (cheese and butter are better than plain milk), but every little helps. Plus, they’re also a good source of calcium, which works alongside vitamin D and is, of course, really important for good bone health.

A side note for vegans and vegetarians: most dietry sources of vitamin D come from animals. Certain mushrooms grown under UV can be a good source of vitamin D2, but unless you’re super-careful a plant-based diet won’t provide enough of this nutrient. So if you live in the north somewhere or you don’t, or can’t, expose your skin to the sun very often, you need a supplement (vegan supplements are available).

Fair skin likely emerged because it allows for better vitamin D production when UVB levels are lower.

One thing I haven’t mentioned of course is skin-colour. Northern Europeans are generally fair-skinned, and this is vitamin D-related, too. The paler your skin, the better UVB penetrates it. Fair-skinned people living in the north had an advantage over those with darker skin in the winter, spring and autumn months: they could produce more vitamin D. In fact, this was probably a significant factor in the evolution of fair skin (although, as Ed Yong explains in this excellent article, that’s complicated).

In summary, consuming dairy does have advantages, at least historically. There’s a good reason Europeans love their cheeses. But these days, if you want to eat a vegan or vegetarian diet for any reason (once again, let’s not get into those reasons in comments, kay?) you really should take a vitamin D supplement. In fact, Public Health England recommends that everyone in the UK take a vitamin D supplement in the autumn and winter, but only a small amount – check your dose.

By the way, if you spot any ‘diary’s let me know. I really had to battle to keep them from sneaking in…

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But no one wants to research that; they can’t make any money from it…

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A couple of my recent posts have focused on potentially dangerous ‘alternative’ treatments for medical conditions. Invariably, such posts generate comments along the lines of “I’ve been using it for years and I’m FINE” and the other favourite “ahhh but They don’t want to research it because it’s cheap and They can’t make any money from it!” (‘They’ is usually the eponymous ‘Big Pharma’).

It’s hard to argue with the first one. The friend of a friend of your uncle’s dishwasher repair main who’s smoked 40 a day for years without ever even getting a case of the sniffles doesn’t believe all that stuff about smoking being bad for you either. No one ever believes the thing they’re doing will turn out to be bad for them. Until, that is, they start getting nasty shooting pains in their left arm.

olaparib

Olaparib costs £49,000 per patient.

The other one though, well, let’s have a look at that. It’s a really common argument, especially from Americans who tend to be much more aware of the cost of medication than Brits. We on this side of the pond are somewhat shielded from the realities of specific costs by the way the National Health Service works. However, some recent decisions by NICE (The National Institute for Health and Care Excellence) have raised the issue of the price of medication in the minds of people over here as well. For example, just a few days ago it was widely reported in the press that NICE had turned down a drug called olaparib (Lynparza) – a targeted treatment for ovarian cancer – because its price tag of more than £49,000 per patient per year was considerably higher than NICE’s upper limit of of £20,000 to £30,000.

£49,000 is a lot of money, no question about it. In some places you could buy a house for that kind of money. At the very least, you could buy a big chunk of a house. For the average household it’s almost double a year’s salary. How could a year’s worth of a drug possibly be worth so much money? Surely the pharmaceutical company (AstraZeneca in this case) are having a bit of a laugh with this price tag? All the way to the bank?

Why ARE medicines so expensive?

Why ARE medicines so expensive?

Well, how much does it cost to develop a drug? A study by the Centre for the Study of Drug Development at Tufts University in Massachusetts reported that the average cost for drugs developed between 1995 and 2007 was $2.6 billion (*see update below) which, based on 2007 exchange rates, is very roughly £1.3 billion. Of course, these figures are from a few years ago – it will be more in today’s market.

Why so much? Well, it takes on average about 12 years to get a drug from the laboratory to the market (and many potential drugs fall by the wayside during the various testing processes). There are a lot of people involved, from researchers in the lab to people running clinical trials to chemical engineers who have work out how to get a small-scale lab production up to something much larger to the people who design and produce the packaging. Even if you just start adding up 12 years worth of salaries (the average salary of a chemical engineer is something like £35,000, for example), you quickly get into big numbers, and that doesn’t take the cost of offices, factories, equipment, raw materials and so on into account.

Back to olaparib and its £49,000 a year price tag. There are about 7000 ovarian cancer diagnoses in the UK each year, but it’s a very specific treatment that would probably only apply to about 450 women each year and it’s estimated to extend life by about a year so, sadly, each patient would probably only be taking it for one year. It’s difficult to get specific figures about development costs, but let’s estimate it took about £1.5 billion to develop it (probably a conservative estimate), and let’s give it 20 years to break even, since after 20 years drugs go off-patent (which means other companies can produce them), and profits immediately drop).

Are pharmaceutical companies really ripping us off?

Are pharmaceutical companies really ripping us off?

Based on those rough numbers, each year the pharmaceutical company would need to make about £75 million. Divide by 450 patients and you get (rounding up a bit) £170 thousand per patient per year – more than three times the price tag NICE was working with. To stress: this is just to cover development costs. I’m not adding any profit on here. Even if you allow for the fact that AstraZeneca are selling the drug in other countries (in the US and Europe in particular), it’s hard to see how their profit margins can be anything more than pretty small.

You might say, so what? This is someone’s life we’re talking about here. Life is priceless. Yes, of course. But unless they can break even, and in fact make some kind of profit, no pharmaceutical company is ever going to invest time in drug development. No one runs a business to deliberately make a loss. Not for long, in any case.

turpentine

Don’t let anyone convince you to swallow this stuff.

There are plenty of people out there claiming that some cheap, every-day substance can cure cancer (could be anything from a type of bleach to turpentine to baking soda, depending on the day of the week), but that ‘Big Pharma’ deliberately suppress these treatments, and/or refuse to research them, because they can’t make thousands selling them, and they would rather push their expensive (but, you know, tested) drugs.

Well no, the pharmaceutical companies can’t sell these kinds of ‘alternative’ treatments, because they’re controlled by extremely strict regulations and they can’t claim something works without rock-solid evidence. But don’t be taken in by the argument that it’s impossible to make a lot of money from selling this kind of stuff. Of course it’s possible: buy it in huge bulk, put it in small bottles with expensive-looking packaging, and the markup can be comfortably generous. Hey, if it’s possible to make money selling ‘ghost turds‘, then it’s possible to make money out of anything. And if you don’t want to actually sell it (which might upset the regulatory authorities) there are book sales, public appearances and private consultation fees. Oh yes, don’t let anyone convince you there’s not plenty of money to be made.

Besides which, it’s simply not true that medical researchers aren’t interested in ‘cheap’ substances. To quote the comedian Dara Ó Briain:

“Oh, herbal medicine’s been around for thousands of years!” Indeed it has, and then we tested it all, and the stuff that worked became ‘medicine’.

Except we shouldn’t be using the past tense; scientists continue to research this kind of thing all the time. Despite what the conspiracists might say, the people who work in these fields are genuinely interested in making people better. If they really thought baking soda could somehow cure a particular cancer, they’d be on it like a shot. Even if you don’t believe they’d do it for ‘the public good’, it’d be worth it for the prestige alone. Someone who managed to prove something like that would almost certainly be up for a Nobel Prize. The company they worked for would be using it in their marketing material forever more. You can’t buy publicity that good. (For more about this, check out this excellent article by Steven Novella.)

beetroot juice

Recent research suggests that beetroot juice could help treat high blood pressure.

Just to prove that research into simple, inexpensive stuff truly does happen, here are some examples (public health warning: I’m not advocating you experiment with any of these, I’m merely listing them to make the point. Discuss it with your doctor before you try anything):

Believe it or not, doctors like medicines that work.

Believe it or not, doctors like medicines that work.

These are just five examples. I’m certain there are many more. Researchers do look at well-known, relatively inexpensive substances if they think they might have a genuine therapeutic effect. That’s the sort of thing scientists do. The difference is that real scientists don’t rely on testimonials – the word of people who’ve “been taking it for years and never been healthier!” – they design proper, rigorous trials.

Sometimes these trials are promising, sometimes they’re not, but the substances that do turn out to be promising invariably find their way into medicine sooner or later because, essentially, doctors like medicine that works.

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* Update: June 2015
After I wrote this post I came across this article on theconversation.com. It casts some doubt on the US$2.6 billion figure from The Tufts Center for the Study of Drug Development, and makes some interesting points about its calculation. In particular, it points out that more than once source has suggested the figure may be over-inflated. This could well be the case, in which case my rough estimate calculations might be off by some margin, but it’s impossible to be more accurate because pharmaceutical companies are pretty cagy about their actual costs. It is certainly the case that a number of pharmaceutical companies have existing, profitable medicines which are reaching the end of their patent lifetime and, it appears, not enough to replace them, leading to some recent mergers and acquisitions activity. A few have run into trouble: Glaxo Smith Kline issued a profit warning last year, as did the French group Sanofi SA. On the other hand, others have been doing extremely well. So are they genuinely over-charging for drugs? It’s a very difficult question, but I think it’s still safe to say that drug development is a very expensive business

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