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Can vitamin D supplementation help relieve the symptoms of depression?

Posted on: July 20, 2012   by  Brant Cebulla

Can vitamin D supplementation help relieve the symptoms of depression?

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This week in The British Journal of Psychiatry, researchers in Norway have published results from their randomized controlled trial studying the effects of vitamin D on depressive symptoms in otherwise healthy adults.

The study, directed by Dr Marie Kjaergaard and a team of doctors out of the University Tromsø in Norway, found that vitamin D did not beat placebo in improving depressive symptoms in a population of people with low vitamin D levels.

The researchers studied the effects of 40,000 IU of vitamin D₃ per week for 6 months. They randomized 231 participants to either a placebo group or the vitamin D group. The participants had baseline vitamin D levels of 19 ng/ml. They also measured at baseline and 6 months:

  • The Beck Depression Inventory (BDI) – a self-completed 21-item questionnaire
  • The Hospital Anxiety and Depression Scale (HADS) – a multiple-choice 14 question survey on depression and anxiety
  • The Seasonal Pattern Assessment Scale (GSS) – a 6 item questionnaire used to assess symptoms involved in seasonal affective disorder
  • Montgomery-Asperg Depression Rating Scale (MADRS) – a 10 question survey assessing depressive symptoms

After 6 months, the vitamin D group’s vitamin D levels rose from 19 ng/ml to a mean level of 59 ng/ml. The placebo group’s levels rose three points to 21 ng/ml. Generally, both the placebo and vitamin D groups’ depression scores improved. However, there was no significant difference between placebo and vitamin D in improving these scores.

In a post hoc analysis, the researchers found a statistically significant improvement in HADS score in the vitamin D group over placebo if the patients started with high scores of BDI, HADS and MADRS. On the other hand, placebo performed better than vitamin D in BDI and MADRS scores if the patients started with low BDI, HADS and MADRS scores. Given this discrepancy, the researchers could not ascertain any difference between vitamin D and placebo.

In further post hoc analysis, there was no difference in the effect of vitamin D supplementation in people that were severely deficient in vitamin D versus moderately deficient in vitamin D. Interestingly, 6 patients dropped out of the placebo group during the study due to “adverse events,” while only 1 patient in the vitamin D group dropped out.

Past studies have found mixed results. These results include:

  • In a study by Sanders et al, a one-time dose of 500,000 IU had no effect on mental well-being in 2258 community-dwelling elderly women.
  • On the other hand, a Vieth et al study found that vitamin D at 4,000 IU/day performed better than 600 IU/day for general well being in a small pool of 130 participants.
  • Furthermore, Lansdowne and Provost reported a significant improvement in mood in 44 healthy subjects who were given either 400 IU or 800 IU of vitamin D in conjunction with vitamin A compared to just vitamin A alone.
  • Lastly, a Jorde et al study administered 20,000 IU or 40,000 IU of vitamin D/week or placebo in 441 overweight women for a year and saw an improvement in the same BDI questionnaire used in this study.

The authors note that the biggest limitation in their study was study length at 6 months in a disorder that may take several years to develop. They call for more research to definitively answer the question if vitamin D plays a role in depression. We also need a better understanding of how vitamin D affects the brain.

Source:

Kjaergaard M et al. Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case-control study and randomised clinical trial. The British Journal of Psychiatry, 2012.

This blog is also running at the Mental Elf, a site that provides quick and snappy evidence-based information for health practice in the UK and further afield. Be sure to check them out!

6 Responses to Can vitamin D supplementation help relieve the symptoms of depression?

  1. hlahore@gmail.com

    Interesting to note:
    A previous study by the same principal author found 36% less depression when higher level of vitamin D. Details at http://www.vitamindwiki.com/tiki-index.php?page_id=3006

    Wonder how many of the patients in Norway were taking cod liver oil – which apparently contains enough vitamin A to block vitamin D.

  2. chrisb

    This wasn’t my experience since supplementing with Vitamin D3: a lifelong sufferer of depression severe enough to warrant antidepressants for a year or more at times, but with little to no improvement with paroxetine and others.
    I read that there was a link between low Vitamin D status and depression so decided to supplement with 10,000ius per day (now 6000ius per day) ; after only 4 weeks there had a been a massive improvement in my mental outlook with no more depression thereafter. Other benefits are a feeling of physical strength and very sound sleep. Supplementing with Vitamin D3 turned my life around from merely existing to enjoying life to the full.

  3. Tom

    Although I’ve never been labeled clinically depressed, for many years I suffered from depression-like melancholy in the spring. I started taking omega-3 (3 grams/day) in 2004 and expected that to have an impact. It seems to me to have had many benefits, including mental (e.g., much faster reaction times; at 64 I can catch things I accidentally drop, which I’ve NEVER been able to do before), but I was disappointed to find no change in the springtime depression. In 2009 I began taking a daily vitamin D3 supplement (now at 5,000 IUs/day) and I haven’t experienced the springtime blues since then.

  4. Ron Carmichael

    This exemplifies the conundrum of hanging your hat on studies as I am so wont to do.
    As an RPh, I tend to only credit what studies (of an appropriate nature and design) might reveal, and this study reminds me that in counseling a patient, I try to never, ever, damage hope nor expectations in someone’s personal convictions as long as it is not harmful to the person (in my professional judgment, such as it may be).
    One can derive benefit from simple, invisible, flavorless air, yes? It stands to my reasoning that studies will not get everything perfectly right, and regardless, a person’s “personal” benefit comes from a belief system that does not arise from a single, nor even several, studies. I have a huge anecdotal experience myself with nutritional capsules that others do not come to believe, despite studies. Such is the nature of the human condition. Perhaps one should simply add this study to your awareness, but do not accept a contradiction in what you “know” effects (not just affects) your “self” health. The suggestion that cod liver oil is not accounted for, gives me some glimmer of hope, betraying my bias.

    • Brant Cebulla

      I would highlight that these patients at baseline were not depressed, so I think it was a tough task for vitamin D to reduce depressive symptoms in people that had little symptoms to begin with. Interestingly, vitamin D did beat placebo in post hoc for people that started with higher depressive scores.

      I am glad the media have not hit this story too hard yet, with titles like “vitamin D no help for depression.” As mentioned in the blog, vitamin D has helped general well being in a few RCTs now. Do depressed patients not deserve general well-being? I think they do.

  5. Rebecca Oshiro

    When I increased my blood levels from 22 ng/mL to 50, the low grade lethargic, depressed state that had characterized my life for years evaporated.

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