Vitamin D deficiency is quite common. Unlike our ancestors, we spend much of our days inside; and, when we do go outside, we shield ourselves from the sun with clothing, hats and sunscreen. Further, much of the food we eat today is processed and lacks the nutrients of the fresh foods that our ancestors ate. According to the CDC, at least one fourth of the population is Vitamin D deficient.
Research has linked low levels of Vitamin D with a number of health conditions, including obesity, diabetes, cardiovascular disease, autoimmune disease, osteoporosis and cancer. And, most recently, several studies have associated some mental health conditions, in particular, depression with a deficiency in Vitamin D.
Depression is a very common condition, with at least 10% of the American population suffering from the affliction; and, 1 in 3 of those cases are severe. Depression is a biological condition and also psychological one, in that it can be triggered by life events such as the death of a loved one, major life changes, physical illness, traumatic experiences, or relationship problems.
Vitamin D levels can become depleted without enough sunshine, especially during the winter months when we tend to stay indoors more and the sun is less intense. Interestingly, there is a spike in Seasonal Affective Disorder (SAD) during the winter season. SAD is a condition commonly experienced in the winter where individuals experience a much lower mood than during the rest of the year, possibly in part due to lower levels of Vitamin D in their blood.
Several studies have found that low levels of Vitamin D produce more symptoms of depression; and, that higher blood levels of Vitamin D correlate with better mood. In one example, researchers at the Department of Psychiatry and Behavioral Neurosciences at St Joseph's Hospital in Hamilton, Ontario reviewed 14 studies, including 31,424 participants and found a strong correlation between depression and low Vitamin D levels.
We have receptors for Vitamin D in our brains, and these receptors are found in the area of the brain linked to susceptibility to depression. Vitamin D may reduce the risk of depression by contributing to the production of serotonin, which regulates mood.
:: The Facts on Vitamin D ::
Vitamin D is a fat-soluble vitamin and steroid hormone precursor. It is commonly known as the ‘sunshine vitamin’ since it is also produced endogenously when our skin is exposed to the sun’s ultraviolet rays. Even just 10-15 minutes a day unprotected in full sun will allow you to generate Vitamin D. However, where you live (i.e. Canada and northern U.S.), the season, time of day, cloud cover and smog will all affect how many International Units (IUs) of Vitamin D are generated. Here in Brooklyn, NY the sun is not strong enough to allow for making vitamin D in the skin in the late fall, winter and early spring. Plus, you need to be sure to expose the skin that is normally covered up in order to make a good amount of vitamin D. And, since sun exposure increases your risk for skin cancer, very few people feel comfortable with this solution and dermatologists strongly discourage sun exposure.
Vitamin D is also present in the flesh of fatty, oil-rich fish like salmon, mackerel, tuna and herring, and in fortified foods, such as dairy products, orange juice, infant formula and cereals. Yet the amount of vitamin D that we get from food is rather limited.
If fatty fish or tropical sun exposure are not realistic for you and your lifestyle, perhaps a daily supplement would be more effective. I recommend taking a supplement of vitamin D3 called cholecalciferol, which is the same vitamin D3 that your body produces.
Vitamin D supplements can be found over the counter in just about every pharmacy and chemist; however, there is a high dose form, containing 50,000 IUs of vitamin D2, which can be obtained by a prescription and only needs to be taken once a week. Vitamin D2 is less potent than vitamin D3.
:: Vitamin D and Your Mental Health ::
Achieving normal levels of Vitamin D could potentially make a big difference in your overall mood and risk for developing depression, anxiety or other psychiatric symptoms. According to a randomized clinical trial conducted by Sepehrmanesh et al., taking Vitamin D supplements can have numerous medical benefits, including an overall relief of stress.
Of course, any decision you make should be discussed first with your general doctor, psychiatrist, or psychiatric nurse practitioner. Vitamin D is safe when taken at reasonable doses as a supplement. Adverse side effects of Vitamin D at doses under 2000 IU per day are unlikely and while vitamin D is only one part of the comprehensive treatment of depression, it may help and it won’t make your symptoms any worse.
It is important to note that Gowda et al. concluded that there was no significant effect of Vitamin D on adults, including a statistically significant reduction in depression for adults. However, this meta-analysis is not definitive as the majority of the 4923 participants over the nine studies considered were individuals with low levels of depression symptoms and a sufficient vitamin D baseline level, so it is difficult to draw conclusions from this study for depressed individuals who are deficient in vitamin D such as many of my patients here in Brooklyn, NY.
However, if you take mega doses of Vitamin D, such as more than 10,000 IUs per day, you may experience Vitamin D toxicity and symptoms such as, weakness, fatigue, sleepiness, headache, loss of appetite, dry mouth, metallic taste, nausea, and vomiting.
Although there are a few foods that contain vitamin D, and not to mention the availability of the sunshine, the best way to ensure you receive your required daily dose of Vitamin D in the fight against symptoms of depression is through a daily supplement recommended by a general doctor or a psychiatrist and regular blood monitoring of vitamin D levels.