Maya Kardouh, Class of 2021
From prior studies, it was determined that there is a negative association between vitamin D levels and the risk of depression in adults. For instance, in pregnant women, low vitamin D levels have been correlated with postpartum depression and quality of sleep. Moreover, a bi-directional Mendelian randomization study revealed the causal effect of depression on low vitamin D levels based on genetic evidence, but could not confirm the contribution of vitamin D to lowering the risk of depression. This connection prompted the question of whether long-term vitamin D3 supplementation would prevent depression in adults (Li et al., 2019; Fallah et al., 2020; Mulugeta et al., 2020; Okereke et al., 2020).
Although the negative association between serum vitamin D levels and depression suggests that vitamin D3 supplementation would be an effective preventative measure for depression, a randomized clinical trial of 50-year old adults and older treated with vitamin D3 or placebo (fish oil) showed no statistical significance between the two groups’ incidence and recurrence of depression over a 5-year follow-up (Li et al., 2019; Okereke et al., 2020). Vitamin D supplementation, on the other hand, has been shown to improve the intensity of benign paroxysmal positional vertigo in patients with vitamin D deficiency (Sheikhzadeh et al., 2016). Furthermore, evidenced by a meta-analysis across two clinical trials, vitamin D supplementation was found to reduce the risk of type 2 diabetes mellitus in nonobese prediabetic patients (Zhang et al., 2020).
A natural way of obtaining vitamin D is by exposing the skin to sunlight, which promotes the synthesis of vitamin D in the body. Sunlight therapy was found to alleviate depressive symptoms and improve the quality of life for patients who have suffered a stroke and depression afterward (Wang and Chen, 2020). The logic behind sunlight exposure as a therapeutic for depression was that light therapy has already been shown to improve depression symptoms in geriatric patients as well as sleep disturbances of Alzheimer patients (Tsai et al., 2004; Dowling et al., 2005). Perhaps, since the skin synthesizes vitamin D upon its contact with sunlight, the association between low vitamin D levels and depression could be explained by reduced exposure to the sun in patients with depression due to an increased tendency to stay indoors. Whether the lack of exposure to sunlight is a direct cause of or mere correlation to depression, sunlight seems to improve depression.
Even though supplementary vitamin D3 has not been proven to prevent depression, vitamin D levels can still be used as an indicator of one’s health, and maintaining normal levels is essential for preventing osteoporosis, cardiovascular diseases, and chronic kidney disease. Further, sunlight has an important role in regulating circadian rhythms by regulating the secretion of melatonin (Wang and Chen, 2020). Therefore, it remains essential to obtain reasonable exposure to sunlight to maintain normal vitamin D levels, and prevent various diseases and disorders, such as depression.
References:
Dowling GA, Hubbard EM, Mastick J, Luxenberg JS, Burr RL, Van Someren EJ. Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. Int Psychogeriatr. 2005 Jun;17(2):221-36. doi: 10.1017/s1041610205001584. PMID: 16050432; PMCID: PMC2387132.
Fallah M, Askari G, Asemi Z. Is Vitamin D Status Associated with Depression, Anxiety and Sleep Quality in Pregnancy: A Systematic Review. Adv Biomed Res. 2020 Jul 27;9:32. doi: 10.4103/abr.abr_188_19. PMID: 33072644; PMCID: PMC7532825.
Li H, Sun D, Wang A, Pan H, Feng W, Ng CH, Ungvari GS, Tao L, Li X, Wang W, Xiang YT, Guo X. Serum 25-Hydroxyvitamin D Levels and Depression in Older Adults: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Am J Geriatr Psychiatry. 2019 Nov;27(11):1192-1202. doi: 10.1016/j.jagp.2019.05.022. Epub 2019 Jun 5. PMID: 31262683.
Mulugeta A, Lumsden A, Hyppönen E. Relationship between Serum 25(OH)D and Depression: Causal Evidence from a Bi-Directional Mendelian Randomization Study. Nutrients. 2020 Dec 30;13(1):109. doi: 10.3390/nu13010109. PMID: 33396887; PMCID: PMC7823924.
Okereke OI, Reynolds CF 3rd, Mischoulon D, Chang G, Vyas CM, Cook NR, Weinberg A, Bubes V, Copeland T, Friedenberg G, Lee IM, Buring JE, Manson JE. Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial. JAMA. 2020 Aug 4;324(5):471-480. doi: 10.1001/jama.2020.10224. PMID: 32749491; PMCID: PMC7403921.
Sheikhzadeh M, Lotfi Y, Mousavi A, Heidari B, Monadi M, Bakhshi E. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study. Caspian J Intern Med. 2016 Spring;7(2):93-8. PMID: 27386060; PMCID: PMC4913711.
Tsai YF, Wong TK, Juang YY, Tsai HH. The effects of light therapy on depressed elders. Int J Geriatr Psychiatry. 2004 Jun;19(6):545-8. doi: 10.1002/gps.1125. PMID: 15211533.
Wang SJ, Chen MY. The effects of sunlight exposure therapy on the improvement of depression and quality of life in post-stroke patients: A RCT study. Heliyon. 2020 Jul 14;6(7):e04379. doi: 10.1016/j.heliyon.2020.e04379. PMID: 32695905; PMCID: PMC7364026.
Zhang Y, Tan H, Tang J, Li J, Chong W, Hai Y, Feng Y, Lunsford LD, Xu P, Jia D, Fang F. Effects of Vitamin D Supplementation on Prevention of Type 2 Diabetes in Patients With Prediabetes: A Systematic Review and Meta-analysis. Diabetes Care. 2020 Jul;43(7):1650-1658. doi: 10.2337/dc19-1708. PMID: 33534730.
Image:
https://remedygrove.com/wellness/Tips-on-How-To-Help-Someone-With-Depression
Although the negative association between serum vitamin D levels and depression suggests that vitamin D3 supplementation would be an effective preventative measure for depression, a randomized clinical trial of 50-year old adults and older treated with vitamin D3 or placebo (fish oil) showed no statistical significance between the two groups’ incidence and recurrence of depression over a 5-year follow-up (Li et al., 2019; Okereke et al., 2020). Vitamin D supplementation, on the other hand, has been shown to improve the intensity of benign paroxysmal positional vertigo in patients with vitamin D deficiency (Sheikhzadeh et al., 2016). Furthermore, evidenced by a meta-analysis across two clinical trials, vitamin D supplementation was found to reduce the risk of type 2 diabetes mellitus in nonobese prediabetic patients (Zhang et al., 2020).
A natural way of obtaining vitamin D is by exposing the skin to sunlight, which promotes the synthesis of vitamin D in the body. Sunlight therapy was found to alleviate depressive symptoms and improve the quality of life for patients who have suffered a stroke and depression afterward (Wang and Chen, 2020). The logic behind sunlight exposure as a therapeutic for depression was that light therapy has already been shown to improve depression symptoms in geriatric patients as well as sleep disturbances of Alzheimer patients (Tsai et al., 2004; Dowling et al., 2005). Perhaps, since the skin synthesizes vitamin D upon its contact with sunlight, the association between low vitamin D levels and depression could be explained by reduced exposure to the sun in patients with depression due to an increased tendency to stay indoors. Whether the lack of exposure to sunlight is a direct cause of or mere correlation to depression, sunlight seems to improve depression.
Even though supplementary vitamin D3 has not been proven to prevent depression, vitamin D levels can still be used as an indicator of one’s health, and maintaining normal levels is essential for preventing osteoporosis, cardiovascular diseases, and chronic kidney disease. Further, sunlight has an important role in regulating circadian rhythms by regulating the secretion of melatonin (Wang and Chen, 2020). Therefore, it remains essential to obtain reasonable exposure to sunlight to maintain normal vitamin D levels, and prevent various diseases and disorders, such as depression.
References:
Dowling GA, Hubbard EM, Mastick J, Luxenberg JS, Burr RL, Van Someren EJ. Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. Int Psychogeriatr. 2005 Jun;17(2):221-36. doi: 10.1017/s1041610205001584. PMID: 16050432; PMCID: PMC2387132.
Fallah M, Askari G, Asemi Z. Is Vitamin D Status Associated with Depression, Anxiety and Sleep Quality in Pregnancy: A Systematic Review. Adv Biomed Res. 2020 Jul 27;9:32. doi: 10.4103/abr.abr_188_19. PMID: 33072644; PMCID: PMC7532825.
Li H, Sun D, Wang A, Pan H, Feng W, Ng CH, Ungvari GS, Tao L, Li X, Wang W, Xiang YT, Guo X. Serum 25-Hydroxyvitamin D Levels and Depression in Older Adults: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Am J Geriatr Psychiatry. 2019 Nov;27(11):1192-1202. doi: 10.1016/j.jagp.2019.05.022. Epub 2019 Jun 5. PMID: 31262683.
Mulugeta A, Lumsden A, Hyppönen E. Relationship between Serum 25(OH)D and Depression: Causal Evidence from a Bi-Directional Mendelian Randomization Study. Nutrients. 2020 Dec 30;13(1):109. doi: 10.3390/nu13010109. PMID: 33396887; PMCID: PMC7823924.
Okereke OI, Reynolds CF 3rd, Mischoulon D, Chang G, Vyas CM, Cook NR, Weinberg A, Bubes V, Copeland T, Friedenberg G, Lee IM, Buring JE, Manson JE. Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial. JAMA. 2020 Aug 4;324(5):471-480. doi: 10.1001/jama.2020.10224. PMID: 32749491; PMCID: PMC7403921.
Sheikhzadeh M, Lotfi Y, Mousavi A, Heidari B, Monadi M, Bakhshi E. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study. Caspian J Intern Med. 2016 Spring;7(2):93-8. PMID: 27386060; PMCID: PMC4913711.
Tsai YF, Wong TK, Juang YY, Tsai HH. The effects of light therapy on depressed elders. Int J Geriatr Psychiatry. 2004 Jun;19(6):545-8. doi: 10.1002/gps.1125. PMID: 15211533.
Wang SJ, Chen MY. The effects of sunlight exposure therapy on the improvement of depression and quality of life in post-stroke patients: A RCT study. Heliyon. 2020 Jul 14;6(7):e04379. doi: 10.1016/j.heliyon.2020.e04379. PMID: 32695905; PMCID: PMC7364026.
Zhang Y, Tan H, Tang J, Li J, Chong W, Hai Y, Feng Y, Lunsford LD, Xu P, Jia D, Fang F. Effects of Vitamin D Supplementation on Prevention of Type 2 Diabetes in Patients With Prediabetes: A Systematic Review and Meta-analysis. Diabetes Care. 2020 Jul;43(7):1650-1658. doi: 10.2337/dc19-1708. PMID: 33534730.
Image:
https://remedygrove.com/wellness/Tips-on-How-To-Help-Someone-With-Depression
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