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Low vitamin D status linked with post-stroke anxiety, according to new study

Posted on: August 15, 2016   by  Missy Sturges & John Canell, MD


A study published by the journal Medicine found that low vitamin D status is associated with a nearly 2.5 fold greater risk of developing anxiety after a stroke.

Nearly everyone has experienced some degree of anxiety in their lifetime. Although feelings of unease or worry can be a normal part of life, when the frequency and intensity escalates, it can interfere with one’s ability to lead a healthy life. Common symptoms of anxiety disorder may include, but are not limited to, hypervigilance, a feeling of impending doom, insomnia, trembling and restlessness.

Post-stroke anxiety (PSA) is a common complication of stroke. In fact, approximately a quarter of patients develop PSA, with over 20% of these individuals suffering from moderate to severe anxiety. Furthermore, research suggests that anxiety negatively impacts the rehabilitation process and long term functional outcome among stroke patients.

Current evidence supports a relationship between vitamin D status and emotional disorders, such as anxiety and depression. Scientists have found vitamin D receptors located in many parts of the brain, including areas that are linked with depression. Since both depression and anxiety share similar neural pathways, researchers theorize that this may be the mechanism by which vitamin D supports mental wellbeing. Additionally, animal studies have shown that vitamin D deficient mice exhibit an increase in anxiety-like behaviors. However, no studies to date have evaluated the role of vitamin D in anxiety among stroke patients.

In a recent study, researchers aimed to determine whether vitamin D status is related to post-stroke anxiety. A total of 226 individuals who had experienced their first ischemic stroke and 100 healthy controls were included in the study. Ischemic strokes occur as a result of inadequate blood flow to the brain. The participants had their vitamin D levels measured within 24 hours of admission. After one month, the researchers evaluated the participants’ anxiety using via the Hamilton Anxiety Scale (HAMA). The HAMA is a standard questionnaire used to determine the severity of the patient’s anxiety symptoms.

Here is what the researchers found:

  • Vitamin D status was significantly lower in stroke patients compared to healthy controls (21 ng/ml vs 26.6 ng/ml, respectively; p < 0.001).
  • Vitamin D status was significantly lower in PSA patients compared to the non-PSA patients (19 ng/ml vs 21.8 ng/ml, respectively; p = 0.02).
  • A total of 26.55% of the patients were diagnosed with PSA.
  • Those with PSA experienced severe strokes (p = 0.02), poorer cognitive function (p = 0.04), decreased functional outcome (p < 0.001) and decreased ability to perform activities of daily living (p < 0.001) compared to those patients without PSA.
  • After adjusting for confounders, vitamin D levels <4 ng/ml were independently associated with a 2.49 fold increased odds of PSA (p = 0.01).

The researchers concluded,

“Serum vitamin D status is related to the occurrence of anxiety in post stroke patients and may be an independent risk factor of PSA after 1 month.”

This is the first study to find a relationship between vitamin D status and post-stroke anxiety. However, it is important to note that the study was limited by its observational design. Therefore, further research is warranted to further validate these findings.


Sturges, M. & Cannell, JJ. Low vitamin D status linked with post-stroke anxiety. The Vitamin D Council Blog & Newsletter, 2016.


Wu, C. et al. Association between serum levels of vitamin D and he risk of post-stroke anxiety. Medicine, 2016.

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