11 votes

Vitamin D and depression: Where is all the sunshine?

11 comments

  1. [3]
    patience_limited
    Link
    It's perfectly sensible to get exercise, get outdoors, eat a balanced diet, and avoid weight gain. All of those things do have research support as helpful with prevention and recovery from...
    • Exemplary

    It's perfectly sensible to get exercise, get outdoors, eat a balanced diet, and avoid weight gain. All of those things do have research support as helpful with prevention and recovery from depression or other forms of ill health. If you think it makes you feel better, keep at it, and by all means seek medical advice periodically or when personal efforts don't seem adequate.

    But ill health also prevents doing many of those things, and that's where Vitamin D research tends to fall apart.

    I hate to be the resident perpetual research skeptic, but the reporting in the linked study is simply awful - no mention of confounders and causation, minuscule sample sizes... I won't belabor the point, but here's a better one: http://www.jneuropsychiatry.org/peer-review/depression-and-vitamin-d-deficiency-causality-assessment-and-clinical-practice-implications-12051.html

    The key finding is:

    Study research shows a relationship between vitamin D deficiency and symptoms of depression. However, it remains unclear if low vitamin D levels are the cause or the effect of depression. Several factors contribute to hamper the studies on the relationship between Vitamin D and depression, including the fact that lack of vitamin D is just one of the many factors that may contribute to depression.

    Practically every tissue in the body has receptors for Vitamin D, so it's likely that it has an impact on health. However, the criteria for determining "deficiency" aren't well understood. https://www.health.harvard.edu/blog/vitamin-d-whats-right-level-2016121910893

    Vitamin D has been promoted as a panacea for all sorts of ailments, but there are significant conflicts of interest at work: https://www.nytimes.com/2018/08/18/business/vitamin-d-michael-holick.html

    Reputable meta-analysis seems to indicate that Vitamin D supplementation has a very few proven health improvements: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802017000500497&lng=en&tlng=en

    Unfortunately, it also doesn't really help much for preventing fractures and falls: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30265-1/fulltext

    The main reason Vitamin D supplementation is an easy recommendation is that it's cheap, well-tolerated and has a high safety threshold for healthy people - you need to exceed recommended doses by a hundred-fold, on a prolonged basis, before there's a risk of acute toxicity. However, if you already have any of a number of conditions (parathyroid problems, aortic calcification, etc.), you really, really should consult a doctor before undertaking Vitamin D + calcium supplementation.

    There's equivocal data suggesting that Vitamin D and calcium supplementation may increase mortality from some causes, though it's potentially an effect of already sick people increasing supplement consumption. http://microbeminded.com/2015/12/03/industry-ties-deeply-influence-guidelines-for-calciumvitamin-d-intake/

    Full disclosure: I take a 400 IU Vitamin D supplement daily, because I have a family history of melanoma and wear full sun protection all the time. I don't take calcium supplements. I exercise, eat a good diet, and spend time outdoors in Florida. I got depressed anyway.

    10 votes
    1. [2]
      DanBC
      Link Parent
      The evidence for exercise as a treatment for depression is weak at best.

      It's perfectly sensible to get exercise, get outdoors, eat a balanced diet, and avoid weight gain. All of those things do have research support as helpful with prevention and recovery from depression or other forms of ill health.

      The evidence for exercise as a treatment for depression is weak at best.

      3 votes
      1. patience_limited
        Link Parent
        I agree, and on the basis of experience, it's not a "treatment" per se. But exercise cessation due to psychomotor retardation from severe depression is a major confounder in most of the studies,...

        I agree, and on the basis of experience, it's not a "treatment" per se. But exercise cessation due to psychomotor retardation from severe depression is a major confounder in most of the studies, and exercise is a good general health support measure.

        "Depression" is so poorly understood, such a giant garbage bucket diagnosis for underlying physiological disorders and long-term responses to socioeconomic stressors, that it's amazing when we have reliable data for anything that works.

        2 votes
  2. [5]
    Neverland
    (edited )
    Link
    I think I’m a pretty stereotypical dude in that I hate going to the doctor. I just finally went and my bloodwork showed something that shocked the hematologist. “I’ve never seen a vitamin D level...

    I think I’m a pretty stereotypical dude in that I hate going to the doctor. I just finally went and my bloodwork showed something that shocked the hematologist. “I’ve never seen a vitamin D level that low. You must feel like crap.”

    My lifestyle has really gotten unhealthy in the last couple years. I stopped riding my bike daily, I sit inside on the PC all night and sleep through part of the day. My diet has also gone downhill, and I have gained some weight. Due to all of this, I got super depressed for a spell.

    I am posting all of this to remind everyone to go to the doctor, even if you feel well, for basic bloodwork. Cholesterol, glucose, vitamins levels, etc. My vitamin D levels are so low that they could be causing depression, muscle aches, lethargy, and more. I’m also getting my butt back in gear on diet and exercise, which used to come naturally to me. But it’s crazy that an inexpensive vitamin could help address all of those issues, which I have.

    Go get checked out my fellow screen-monkeys! If you really can’t adford to got to the doc, get some vitamin D and take it for a couple months.

    8 votes
    1. Gaywallet
      Link Parent
      I've been taking calcium/d/k pills for a while now. I drank a lot of soda when I was a kid. In my early 20s I went to a doctor and they told me I had osteopenia, so onto pills I went. Honestly,...

      I've been taking calcium/d/k pills for a while now. I drank a lot of soda when I was a kid. In my early 20s I went to a doctor and they told me I had osteopenia, so onto pills I went.

      Honestly, calcium/d/k pills are good for just about anyone. Unless your doctor says you specifically shouldn't be on them, stronger bones and teeth are good. The extra vitamin D will prevent issues like this as well and K is important for neural health.

      2 votes
    2. [3]
      ali
      Link Parent
      Hope you're getting vitamin supplements. After I spent a year in Australia, I went back to Germany and during the winter I felt so bad as well. Taking vitamin D supplements really helped me since...

      Hope you're getting vitamin supplements. After I spent a year in Australia, I went back to Germany and during the winter I felt so bad as well. Taking vitamin D supplements really helped me since then.

      1 vote
      1. clerical_terrors
        Link Parent
        Same, I moved back to the Netherlands from France and I'd been feeling down for a while. Went to see the doctor and he recommended vitamin supplements as well.

        Same, I moved back to the Netherlands from France and I'd been feeling down for a while. Went to see the doctor and he recommended vitamin supplements as well.

        2 votes
      2. Neverland
        Link Parent
        Oh yeah, I’m on it. I moved from Florida to Southern California, to Poland. Pretty dumb of me not to think about this.

        Oh yeah, I’m on it. I moved from Florida to Southern California, to Poland. Pretty dumb of me not to think about this.

        1 vote
  3. [3]
    patience_limited
    Link
    So I thought I remembered seeing something about this recently: https://www.nejm.org/doi/10.1056/NEJMoa1809944 No evidence whatsoever that Vitamin D prevents cancer, heart disease or mortality...

    So I thought I remembered seeing something about this recently: https://www.nejm.org/doi/10.1056/NEJMoa1809944

    No evidence whatsoever that Vitamin D prevents cancer, heart disease or mortality from any cause, in an enormous, well-designed study.

    3 votes
    1. [2]
      Neverland
      (edited )
      Link Parent
      My hematologist only mentioned that super low vitamin D like I had (4.8 ng/ml) in my tests can cause muscle aches, lethargy, and possibly depression. I’m not talking about some supplement crap...

      My hematologist only mentioned that super low vitamin D like I had (4.8 ng/ml) in my tests can cause muscle aches, lethargy, and possibly depression.

      I’m not talking about some supplement crap here, I am talking vitamin deficiency.

      Edit: now I’m really confused, are you replying to the link posted here in any way? It seems like you are replying to some other claims that no one here is making, or did I miss something in the linked piece?

      2 votes
      1. patience_limited
        Link Parent
        I'm not saying you didn't need it - that's hella low. You got tested in the context of a high index of suspicion (northern latitude, low outdoor exposure, etc.), and they presumably checked for...

        I'm not saying you didn't need it - that's hella low. You got tested in the context of a high index of suspicion (northern latitude, low outdoor exposure, etc.), and they presumably checked for other causes of truly low vitamin D - gastrointestinal disorders, kidney disease, and so on.

        But global recommendations for supplements in people who otherwise have sufficiency aren't justified, or even a good idea. Supplements can mask other underlying diseases, like malabsorption from celiac or other GI disorders.

        1 vote