Vitamin D again linked with anti-depressant effects

Vitamin D is less a vitamin and more a hormone, and higher levels of this substance are linked with a reduced risk of many conditions including multiple sclerosis, heart disease and several forms of cancer. In some studies, vitamin D has been tested as a treatment, and at least some evidence points to it having value here, including evidence which finds vitamin D can have mood-enhancing and anti-depressant effects [1].

I came across this relevant report today, which gives an account of a ‘case series’ presented at a recent scientific meeting. It tells of three women suffering from major depression and, at the same time were, were found to be deficient in vitamin D. Vitamin D supplementation improved their vitamin D levels, but even more importantly, appeared to significantly reduce their depression scores too.

These case reports are interesting, I think, and looking for vitamin D deficiency and correcting it appears to be a valid strategy in depression. However, it’s also wroth bearing in mind that while case reports can help stimulate thinking and point the way to future research, they don’t prove or disprove much at all. The usefulness of vitamin D as a treatment for depression can only really be ascertained with any degree of certainty through what are termed ‘randomised controlled trials’ (the sort of trials used to assess the effects of pharmaceutical agents). I think it would be a great service to us for appropriately designed studies to be understaken and the results see the light of day. Certainly, we have a least some evidence [1] which suggests vitamin D has genuine potential as an antidepressant.

That said, the absence of these trials will not stop me looking for and correcting vitamin D in my patients (whether they are depressed or not).

I realise that burgeoning interest in vitamin D has led to increasing numbers of people wanting to have their vitamin D levels checked. Increasing numbers of doctors seem happy to oblige (at least here in the UK). However, I also know that some doctors refuse their patients which can be frustrating. In the UK, there is a very good (and quite economical) self-testing service here. In the US, self-testing services are available too (see here and here for examples).


1. Jorde R, et al. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264(6):599-609

18 Responses to Vitamin D again linked with anti-depressant effects

  1. Rachel 26 June 2012 at 2:44 pm #

    I think doctors in the UK are becoming more aware of the effects of vitamin D. Only in the past week on the hospital ward where I work we’ve had two patients put on treatment for low vitamin D levels and I’d never even heard it mentioned before.
    Personally, since starting to take vitamin D supplements I’ve been able to reduce the dose of my antidepressants down from 20mg to 2.5mg and I’ll soon stop taking them altogether. Yes, this is only anecdotal evidence and there are other factors to consider, but I really believe it has helped.

  2. ProudDaddy 26 June 2012 at 2:45 pm #

    I just posted a comment at about diagnosing/treating to the mean. If 10% of RCT subjects were 100% cured by a treatment, it probably wouldn’t pass the significance test. When are all these trials and studies going to start delving into the individual differences responsible for different results so that treatment can use a rifle instead of a shotgun?

    A study gets mixed results. What’s the recommendation? A larger study!

  3. Jean 28 June 2012 at 12:46 am #

    I think most old people in care homes must be vitamin d deficient. In my mother in law’s home they rarely go out, even in the summer.

  4. Ted Hutchinson 28 June 2012 at 6:46 pm #

    Dr Briffa provided a link to CityAssays Vitamin D blood spot test in a recent Vit D thread. It’s easy to drop a couple of blood drops onto test strip and the results get emailed back to you very promptly.
    Vitamin D works best as an anti-inflammatory agent when 25(OH)D is at or above 125nmol/l (= 50ng/ml) Human skin is set to produce anti inflammatory vitamin D from dawn to dusk and anti-inflammatory MELATONIN from dusk to dawn.
    Human production of both Vit d and Mel declines as we age.
    People who stay indoors (care homes) will not be making either.
    In the same way you need midday sun exposure on skin to create vitamin D3 the same BRIGHT LIGHT exposure recalibrates circadian rhythm and enables night time melatonin secretion (providing evening light is subdued and night is totally dark)

  5. Greg Venning 29 June 2012 at 11:02 am #

    When do you think we’ll stop seeing the issue as “benefits” of additional vitamin D and regard the issue as a deficiency? It’s as if we were saying that water is a useful supplement in treating dehydration. Vitamin D is a required nutrient for health and, just like water or oxygen, when we have it in the right quantities then we see higher levels of health (in many measurements) when we compared to people who are deficient in it.

  6. kevmusic 29 June 2012 at 5:20 pm #

    Don’t forget the importance of considering your magnesium levels if you increase your intake of vitamin D. The two work together and if you increase vitamin D, it can lead to a deficiency in magnesium in some people.

  7. kate 29 June 2012 at 11:31 pm #

    My doctor does include Vitamin D in his chem profile at my yearly physical. For a few years now, I have been taking regular vitamin D supplementation. Gradually, my levels have gone up (and it has been very gradual) to show a normal level in my chem results. This year, my supplement has been even higher – I’ve taken my D supplements religiously. The results should be interesting when we discuss this at my visit for my yearly physical this summer. BUT I have never been as consistently depressed, every day. Another topic for conversation – with my doctor!

  8. Ted Hutchinson 30 June 2012 at 1:26 am #

    @ kate
    What matters with Vitamin D3 is not the amount of supplement you take but the 25(OH)D level you achieve.
    Ideally try to stay at or above 125nmol/l or 50ng/ml as at this level it’s most effective as an anti-inflammatory agent, depression may well be a result of inflammation of the brain.
    Unfortunately the levels regarded as “NORMAL” by most health professionals are well below the “NATURAL” levels for humans living mainly outdoor lives as human DNA evolved.
    To enable the circulating form of Vitamin D to switch to the active hormonal form requires the presence of MAGNESIUM, many people do not have sufficient magnesium in their diets. This could be a factor why you do not as yet feel the full benefit of having raised vitamin d status.
    Just as the human body is set to produce the anti inflammatory agent vitamin D3 from dusk to dawn so from dusk to dawn it creates the anti inflammatory MELATONIN. Dr Briffa has written several posts relating to sleep A brief guide to better sleep is a good starting point.

    Vitamin D, Magnesium and Melatonin act together as neuroprotective agents amongst many other pleiotropic roles, it’s important that all three are optimized as the same time as they work better as a team.
    Getting outside into bright sunlight it even more important that just improving vitamin D status and resetting circadian rhythm and so increasing melatonin secretion.
    Adequate BRIGHT LIGHT exposure in the morning may also (given a proper breakfast) may also improve your mood through the day.
    Can breakfast Tryptophan and Vitamin B6 intake and morning exposure to sunlight promote morning-typology in young children aged 2-6 years?”

  9. Dawn 3 July 2012 at 3:52 pm #

    I had so much hope for D3, I have a CFS/FM and I am on antidepressants. Unfortunately after the initial benefit the second day calming my breathing and giving me energy I started with severe mental disturbances and terrible bone pain which unfortunately now persist on and off even without the D3.
    I tried again because I really wanted the benefits and all the horrible effects happened again.
    Has ANYONE any ideas what I can do about this?
    I am so happy for those who can take it and feel better from it.
    kindest regards,

  10. Elfreda Cormode 4 July 2012 at 3:36 pm #

    I read recently that the current mania for sun block creams and covering up every inch of skin when out in the sun is causing us to become severely Vit D deficient. (The case for skin cancer being caused by sunexposure far from proven!) We also hear that children are not making sufficient Vit D to grow properly and that cases of repeated broken bone are increasing fast. A friend’s grandson has now had two broken arms – from not very bad falls – in the last 6 months which worries her and seems to demonstrate this trend. Maybe we need to ‘get out more’ and leave the sunblock alone – just use our common sense to avoid sunburn, and little and often thinking!

  11. Ted Hutchinson 4 July 2012 at 5:48 pm #

    @ Dawn.
    Vitamin D3 is biologically identical to cholecalciferol formed near the surface of your skin when UVB from sunlight acts on the 7 dehydrocholesterol molecule in your skin.
    It seems hard to work out a mechanism by which people become allergic or over-sensitive to substances created by their own DNA.
    As vitamin D3 is naturally created on or near the surface of the skin perhaps you would find this a more suitable route than taking oral supplements?
    You may want to consider using REGULAR SHORT NON BURNING sessions under a sun-bed with UVB rich tubes. I bought a second hand sunbed of EBAY (there are usually some under £50) and replaced the tubes with ones with the highest UVB output I could find. (these will cost more than the second hand sunbed BUT it’s the UVB that produces Vitamin D3 not the UVA (which does the tanning). It may be worth asking your local tanning studio if they have beds with higher UVB output tubes and if you could have a series of very short sessions rather than longer sessions. Your purpose would not be to get a tan but to first harden your skin to UV exposure while also increasing vitamin D levels. If you want to consider UV exposure (and UK sunshine doesn’t seem to be an option this year) it would be worth your while improving your natural sunscreen potential and by using some of the suggestions here.
    If that doesn’t appeal to you then think about using the contents of Vitamin D capsules massaged directly onto your skin. Or you may want to get Vitamin D drops onto your skin preferably applies somewhere the sun doesn’t shine. (UVA from sunlight processes Vitamin D3 into suprasterols the body doesn’t use).
    The 5000iu Vitamin D drops readily available from places like Amazon UK or BigVits are very tiny so contain nothing except a smidgen of olive oil containing the cholecalciferol.
    Whichever way you obtain vitamin D3 you also need to understand it takes a while for it to be absorbed and available for your body to use. Even with UVB exposure it will be several hours before any vitamin D is created and it will be several DAYS before any change in 25(OH)D is measurable in your blood. It’s also worth pointing out that vitamin D3 is fat soluble. If you first lay under UVB (sun or tanning lamp) then later in the say (in fact within 48hrs) go for a run (work up a sweat/play tennis) and then go for a swim/shower it’s possible that the oil in your sweating could bring the newly created to the skin surface which swimming/showering could remove. (Many outdoor athletes, marathon runners, cyclists) end up with extremely low vitamin D levels despite (or maybe because) they train hard (get sweaty) outdoors.
    If you took 50,000iu today the maximum benefit from that oral dose would not be fully reflected in a 25(OH)D blood test until 14 days from today. If you are having immediate reactions to taking vitamin d it’s possibly something other than the cholecalciferol (capsule/carrier oil) causing that reaction. Do be aware that even the use of placebo medications produce side effects in vulnerable people.

  12. HLPain 5 July 2012 at 9:06 am #

    Nature seems to be having solution for everything, vitamin D can be found in the sun’s rays so even where one cannot afford supplements, getting 15mins of the Sun can help in a great way.
    Kudos this is a great article

  13. HLPain 6 July 2012 at 6:56 pm #

    Thanks Elfreda,
    It’s true nature has a lot of solutions to our illnesses

  14. Elfreda Cormode 7 July 2012 at 2:03 am #

    I so agree with HLPain – what a novel idea that ‘…nature should have a solution for everything…’
    Is this common sense breaking out at long last? Let’s hope so!

  15. Karen 15 July 2012 at 5:30 pm #

    Dawn, Your GP should report cases of reactions such as yours to the pharmaceutical company concerned. If he hasn’t/won’t, you can do it yourself. The only way problems such as this can be identified is if someone lets the companies concerned know. I am actually a recorded case of having similar reactions to yourself – unfortunately only one of three. Also, the company will be reluctant to record it if you are no longer on the product. Tell them you’re going to try taking it again.
    I would also suggest you might like to get your stomach acid levels checked. Stomach acid can be low as well as high. If it is low you will have problems absorbing many substanstances, one of which is calcium. If you take d3 and force the levels up, you also force the release of calcium. This cannot be absorbed because of low stomach acid so then can cause problems. The test you have done is for hypochlorhydria and you have to pay for privately and also have to have a letter from either your GP or a private practioner. I mention all this because my reaction to d3 was exactly the same. I also have low b12 and would recommend that you ask your GP to check that because again low stomach acid stops b12 being absorbed (unfortunately the serum b12 only measures the amount in your blood stream but your levels should be on the low end anyway.)

    Additionally d3 levels are best kept above 50 because the body actually starts to store it above this range. That means if you get it high enough in summer you will have better stores to carry you over the winter.

  16. Ted Hutchinson 15 July 2012 at 7:52 pm #

    50nmol/l = 20ng/ml generally regarded as deficiency status.
    80nmol/l = 32ng/ml is the level at which calcium absorption is optimal for most people (there will be outliers for whom Bone Mineral Density will not occur until they are in the upper 45 ~ 50ng/ml 100~110nmol/l.)
    100nmol/l = 40ng/ml is generally regarded as the level at which daily vitamin D3 needs are met and ensures mothers basic vitamin d needs are met through pregnancy (probably takes m inimum of 4000iu/daily but will vary according to latitude, altitude, cholesterol level, BMI, city/rural location and many other factors.)
    50ng/ml = 125nmol/l is the level at which storage of vitamin D actually begins (as there is then more available than required for daily needs. This is the level humans living mainly outdoors near naked achieve vit d equilibrium.
    60ng/ml 150nmol/l the human body has sufficient stored D3 to pass surplus to the next generation in human milk, so breast milk is vitamin d replete.

    In South Carolina Hollis and Wagner fouind it took 6400iu/daily to produce vitamin D3 replete breast milk. I suspect this summer in the UK most mothers will require more than 6400iu to achieve the same.
    CityAssays vitamin d3 blood spot tests are available at £25 If you buy 10 and share them with your friends/relatives/workmakes/onlline buddies you can all save £5 per test and get a bulk pack for £20 each.
    I think we should be careful about our choice of words.
    Vitamin D3 does not FORCE the absorption of calcium.
    It is more true to say that raising vitamin D3 status above 32ng/ml 80nmol/l ENABLES the optimum absorption of calcium from dietary sources.

    The average UK adult normally goes from around 30nmol/l at the end of winter to around 75nmol/l at the end of summer but it will depend on the quality of the summer.
    Hypovitaminosis D in British adults
    The only people who will be at that level this year are likely to be those who have booked a holiday in the Canaries or similar or who are taking 5000iu/daily D3 from a supplement.

    Remember NO ONE is obliged to take vitamin D3 orally.
    It’s a fat soluble vitamin.
    Coconut oil or any other edible massage oil provide a suitable carrier.
    Put your daily vitamin D3 drops on the massage oil and massage it into your skin.
    UVA degrades Vitamin d3 (it processes it to suprasterols the body doesn’t use) so best skin to massage D3 into is skin normally covered by clothing.
    (or have a vit d massage early evening when indoors but don’t shower after it)
    If you are going the massage route rather than orally may I suggest you drop 7 days worth of Vitamin D3 (14 drops x 2500 = 35,000 iu) into the coconut oil (or other massage oil) then you need only do this once a week.)
    This would also be a good way to get kids to get vitamin D3 if the sun isn’t reliably available.
    Working on the basis of 100 iu daily for each 2.5 lbs the child weighs should be fine.
    Remember that when May Mellanby did the early work on vitamin D with children and rickets she used a single massive dose of 600,000 IU of vitamin D2 as a supplement. None of the children showed any toxic manifestation after the administration of the single massive dose of vitamin D.
    We now know Vitamin D3 is more effective than D2. It’s more natural to use a lower amount (equivalent to that obtained playing naked in the sun for an hour or so without burning) more regularly to prevent massive swings in Vitamin D status.

  17. Karen 17 July 2012 at 1:56 pm #

    I think we should be careful about our choice of words, you are correct. But sometimes vitamin d3 limits itself in order to protect the body from calcium absorption. If we use your choice of words in ENABLE (I like that word) but the body cannot, for whatever reason, utilize that calcium effectively, and it could actually be dangerous to the body, then vit d tries to protect the body from that happening.
    I’d not thought about using it on the skin – I’ll look into that one when I’ve got a mo.

    I think as well that, ooh, dicey memory, was it May Mellanby that did the vitamin d tests and then put magnesium into the equation???? But she did use d2 and that’s a different ball game. Tends though, I think, to be what manufacturers use when adding to food?

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