New Randomized Controlled Trial: Vitamin D Helps in Depression

A new randomized controlled trial out of Iran and published in the Journal of Clinical Psychopharmacology reports that vitamin D may help depression.

Past research has shown a definite association between low vitamin D levels and depression. However, clinical trials have shown mixed results, thus raising need for further research. The researchers in this study led by Dr Hassan Mozaffari-Khosravi wanted to know if a single injection of vitamin D could help improve symptoms in those who suffered from mild to moderate depression.

One-hundred and twenty people were recruited from specialist clinics at Yazd Shahid Sadoughi University of Medical Sciences and enrolled into the study. They only enrolled people between the ages of 20 to 60, had presented depression at specialist clinics, scored higher than a 17 on the Beck Depression Inventory II test (BDI) and had a vitamin D level lower than 16 ng/ml.

The BDI is a 63 point self-assess scale, with a score of 63 indicating severe depression, a score of 0 indicating no depressive symptoms. Scores in the range of 11-16 indicate mild depression, while scores 17-20 indicate the need for psychological consultation, so all participants scored at least just above mild depression.

The researchers evenly divided the participants into three groups. One group to receive a single shot of 300,000 IU of vitamin D (300k), another group to receive a single shot of 150,000 IU (150k) and another group to receive nothing, serving as a control group. The third group did not receive a fake shot, so this was not a double blind study, just a randomized controlled trial.

Here were the baseline findings:

  • Mean vitamin D levels were very low. The mean level was 10.1 ng/ml in the control group, 9.2 ng/ml in the 150k group, and 8.5 ng/ml in the 300k group.
  • Mean BDI scores were similar among groups, ranging from 26.4 to 27.5.

The researchers then administered the vitamin D. After three months, the researchers had participants take the BDI again to assess depression to see if improved vitamin D levels helped at all. Here is what they found:

  • Mean vitamin D levels increased to 24 ng/ml in the 300k group, 21.8 ng/ml in the 150k group and stayed low in the control group at 11.3 ng/ml.
  • The severity of depression improved in all groups, as assessed by decreasing BDI. However, the 300k group improved the most.
  • BDI decreased by 9.3 points in the 300k group (26.7 to 17.4).
  • BDI decreased by 6.8 points in the 150k group (27.5 to 20.6).
  • BDI decreased by 2.1 points in the control group (26.4 to 24.3).

The difference in BDI decrease between the 300k group and the 150k group and the difference in BDI decrease between the 150k group and the control group was not statistically significant. However, the difference in BDI decrease between the 300k group and the control group was statistically significant, suggesting that vitamin D may have had an effect in improving depression.

The authors conclude,

“The findings of this study showed that first, vitamin D deficiency in patients with depression has a high prevalence; second, the correction of vitamin deficiency improves depression in these patients; and third, the single dose of 300,000 IU of vitamin D is safe and more effective than 150,000 IU.”

The greatest limitation in this study was that the trial wasn’t double blinded, so we don’t know if there was an extended placebo effect in the people that received shots compared to the control group that didn’t However, the fact that the 300,000 IU vitamin D group showed statistically significant improvement in depression over the control group and the 150,000 IU group did not, hints that the vitamin D shots were not just a placebo effect and that the more vitamin D administered, the better the improvement.

There were some strengths in this study compared to previous randomized controlled trials looking at vitamin D and depression. In a study out of Norway last year, researchers wanted to see if 40,000 IU/week improved depression and found that it didn’t. However, their participants for the most part did not suffer from depression. They also used the BDI scale and found the median participant started at only 4 points, compared to the mean of about 27 points in this Iranian study. Thus, there were few depressive symptoms to improve upon in the Norway study. In this Iranian study, participants suffered from mild to moderate depression, so there was much more room for improvement.

The Vitamin D Council does not recommend the use of single loading doses like the ones used in this study. After three months, vitamin D levels were still low in the 300,000 IU group. Rather, the Vitamin D Council recommends use of daily maintenance doses of 5,000 IU/day in adults to achieve levels of 50 ng/ml. Please see our ‘How do I get the vitamin D my body needs’ page for more information.

Also visit our patient friendly summary on depression for an overview on the subject. Note that the summary is a little outdated now, as there have been a couple of trials on depression and vitamin D since we last updated it.

Mozaffari Khosravi H, et al. The Effect of 2 Different Single Injections of High Dose of Vitamin D on Improving the Depression in Depressed Patients With Vitamin D Deficiency: A Randomized Controlled Trial. J Clin Psychopharm 2013.

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Mushrooms may be good source of vitamin D

Vitamin D has many known benefits. A new study shows that there may be a natural and tasty way for individuals to get this nutritional supplement.

Finding a means beside sun exposure to attain sufficient levels of vitamin D may be helpful. The American Academy of Dermatology notes that ultraviolet radiation from the sun can cause skin cancer to develop. Therefore, finding an alternative source of the vitamin that is part of a healthy diet could be advantageous.

Mushrooms may be a vitamin D source
Boston University Medical Center found that eating mushrooms with vitamin D2 may effectively help increase vitamin D levels as much as taking a supplement of vitamin D2 or vitamin D3.

Researchers claim that mushrooms absorb vitamin D similarly to how human skin does – by being exposed to ultraviolet light. Therefore, any mushrooms that grow under the sun likely attain this nutrient. Additionally, according to the study, these mushrooms produce vitamin D3 and vitamin D4 when exposed to UVB rays.

During the study, researchers surveyed 30 healthy adults. Different members of the study group either took capsules with 2000 International Units of vitamin D2, 2000 IU of vitamin D3 or 2000 IU of mushroom powder. This mushroom extract contained vitamin D2. The participants took these pills once a day.

The results showed that all the participants, whether taking a regular nutritional supplement or a mushroom-based pill, had the same vitamin D levels. In all three groups, the vitamin D levels increased gradually then remained level after seven weeks. Five weeks later, the participants maintained these vitamin levels.

“These results provide evidence that ingesting mushrooms which have been exposed to ultraviolet light and contain vitamin D2, are a good source of vitamin D that can improve the vitamin D status of healthy adults,” Michael Holick, Ph.D., lead investigator of the study, said.

Vitamin D may benefit women
Beside the general health benefits of vitamin D, the nutrient may help women reduce their risk of getting uterine fibroids. The National Institutes of Health recently published a study noting that women who maintained adequate levels of vitamin D decreased their chance of developing fibroids – benign tumors on the uterus – by 32 percent.

“This study adds to a growing body of literature showing the benefits of vitamin D,” Linda Birnbaum, Ph.D, director of the National Institute of Environmental Health Sciences said.

By potentially maintaining substantial levels of vitamin D through a healthy diet that includes mushrooms, individuals may be able to experience these health benefits.

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Vitamin D is a source of strength

Some people may overlook the power of vitamin D, especially in the context of physical strength and endurance.

This oversight could lead to cases of deficiency. According to a 2011 brief by the Centers for Disease Control and Prevention, between 2001 and 2006, about 8 percent of the American population was in danger of having a vitamin D deficiency.

Recent studies suggest that for those, including athletes, who want to maintain both muscle and bone strength, vitamin D may be essential.

New research for vitamin D
The consequences of a lack of vitamin D show its potential power as a supplement. For example, a study recently found that those with a vitamin D deficiency may experience physical fatigue.

Researchers from Newcastle University studied individuals with vitamin D deficiencies after they performed leg exercises, analyzing their phosphocoreatine recovery. Phosphocoreatine is an energy source in muscles: The scientists wanted to discover how quickly it is replenished following muscle use.

After studying the patients in their deficient state, researchers treated them with vitamin D supplements. Once they took the vitamin dose, patients had significantly better phosphocoreatine recovery. Additionally, patients felt less fatigued after the supplementation.

“Patients with vitamin D deficiency often experience symptoms of muscle fatigue. Our findings in a small group of patients with very low vitamin D levels show that muscle efficiency significantly improves when vitamin D status is improved,” Akash Sinha, M.D., leader of the study, said, reported by the news source.

Those looking for increased muscle strength might take heed of these findings and implement vitamin D to stay in shape.

Vitamin D is essential in athletics
A recent Miami Herald article cited the importance of vitamin D on the sports scene.

Following the Florida Panthers, the news source explains that many players with muscle or bone injury did not have a full recovery, or else experienced reinjury. The team doctors overseeing these injuries believe the underlying problem for these athletes may be vitamin D deficiency.

“Five years ago if you went to a sports medicine meeting you wouldn’t hear anything about vitamin D. But recently there’s been a lot of attention on how it relates to muscle and bone health and healing,” said Gautam Yagnik, M.D. one of the doctors for the Panthers, as reported by the Herald.

By upping the use of vitamin D, as emphasized by recent studies, the athletic world may see fewer injuries and better recoveries.

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Some ideas for maintaining bone health

It’s important for people of all ages to get plenty of calcium to ensure their bones stay healthy, but especially for those of us who are growing older, it’s important to maintain optimal bone health.

According to the National Osteoporosis Foundation, approximately 44 million people in the U.S. have developed osteoporosis – also known as low bone density – which puts them at greater risk of fracture. In fact, half of all women over the age of 50 are said to have the condition, and the same can be said of about 25 percent of men. When osteoporosis sets in, it doesn’t take much to cause a bone fracture. This is an extreme example, but the source notes that something as seemingly low-impact as a sneeze can break a bone if a person’s bone density is low enough.

But as is the case with many health conditions, there are steps people can take in advance to strengthen their bones, and potentially reduce the odds that osteoporosis ever occurs.

Get plenty of omega-3 fatty acids
The experts at Healthy Women promptly point out omega-3 – the good kind of fatty acid – on its list of bone health preserving steps. The source explains that although many people are already aware that omega-3s, which are abundant in fish oil, they might not know that fish can help reduce inflammation and, thereby, help improve heart health. It seems that omega-3 fatty acid is good for the formation of bones, while omega-6 – increases the odds of experiencing bone problems at some point in the future.

Ditto for vitamin D
Vitamin D has been known to help with emotional health, as well as maintain skin health. Healthy Women states that it may also benefit bone health in significant ways. According to the source, vitamin D allows the body to make the best use of calcium, and makes it so blood doesn’t have to drain resources such as calcium from bones. Supplements are encouraged by Healthy Women, with consideration for how sunlight isn’t always easy to come by, depending on where a person lives. Even if a person is already on medications for osteoporosis or other bone degenerative conditions, it might be a good idea to take vitamin D and calcium supplements to maximize bone health.

Be mindful of general health matters
Smoking and drinking too much may put a person at risk for developing all kinds of cancers. But they could also increase the risk of osteoporosis, according to the National Institutes of Health. Smoking makes it more difficult for body to retain calcium, and alcoholism has also been connected with a higher osteoporosis risk, according to the NIH. In addition – just like muscles – bones become stronger when they’re used regularly, so leading an active lifestyle may enhance bone health while also bringing a person closer to achieving other health objectives. The same goes for proper weight management – being underweight or overweight have both been linked to poor bone health.

Consume low-fat dairy, and other calcium-fortified substances
Most people may assume that some foods are better for bone health than others, but not everyone may know which are best. The National Institutes of Health points out that many supermarkets and other food services provide calcium-fortified versions of foods that may not have originally been loaded with calcium, including tofu, soy milk and orange juice. Leafy vegetables, Chinese cabbage and nuts are also NIH-approved for the calcium content. But drinking low-fat milk may be the easiest way to boost a person’s calcium intake.

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For vitamin-insufficient population, food options are wide for vitamin D

Vitamin D fanatics may spend hours at the beach catching tans to increase their levels, but there are also nutrient-rich foods packed with the key vitamin and available at a store near you.

According to Men's Health, only 3 ounces of wild salmon can provide 112 percent of your daily value of the vitamin. Not only is wild salmon delicious – it's also high in omega-3s, which are polyunsaturated fatty acids known for their potential to improve metabolism. According to the FDA, one three to six ounce canned salmon serving can provide as much as a week's worth of omega-3s.

People have been pairing salmon with bagels and cream cheese for years, but more varied options also exist, such as mixing it with avocado to get more heart-healthy fats, or adding lemon juice or capers for taste. If you're in a hurry, salmon even goes well with toast.

But salmon isn't the only chicken of the sea with vitamin D and omega-3s. Tuna, in addition to being a good source of protein, also has a healthy amount of vitamin D. This fish goes well with pickles, lettuce and mayonnaise. Just avoid buying tuna that comes packaged in a can. While canned salmon has mercury levels below FDA detection, canned tuna has at least 35 times more mercury, according to the ocean conservancy group Oceana.

Tuna with healthy mercury levels will be labeled as "chunk tuna" or darker meat tuna, provided by a different species than the "white" or "chunk light" tuna often found in cans. The darker tuna is smaller, and smaller fish take in less mercury.

Fruit & Dairy
Orange juice is also well-known for its richness of vitamin D, with one cup providing about one third the average daily value. Fortified Milk also includes the vitamin in moderate amounts, and you're likely to find vitamin D enriched milk in supermarkets. Other dairy products like yogurt also contain vitamin D. Yogurt is also a great snack for post-workout, when your muscles need protein for repair.

Vitamin D performs a number of key functions in the body, primarily in the absorption of calcium and phosphorus, which have been shown to boost bone health. In the body, the active form of the vitamin is called Calcitriol, and it has been linked to increased calcium absorption in the kidneys as well as greater percentages of the mineral in the bloodstream.

Population deficiencies
Data from the 2009 National Health and Nutrition Examination Survey showed that nine percent of children in the United States are deficient in vitamin D (lower than 15 ng/mL in blood), with 61 percent vitamin D insufficient (15 to 29 ng/mL). While vitamin D is generated through sun exposure, the evidence is clear that many may not be getting enough sunlight to get optimal levels of the key compound. Increasing vitamin D intake through food may be a good way to supplement diet regardless of sunshine exposure.

Vitamin C
Another vitamin easily available in foods is vitamin C, for which the most famous example is perhaps oranges. Vitamin C may raise immune system health and has been linked to higher levels of iron absorption.

Other foods high in the vitamin include guava fruit, kiwis, red and green sweet peppers, grapefruit, strawberries, cantaloupe and brussel sprouts. Strawberries are also high in fiber and antioxidants, and a red pepper can boast more than 100 mg of vitamin C, according to numerous studies.

Next time you go out to eat, you might want to try some lox with a side of orange juice, or there may be some yogurt or kiwis lying around to mix into a vitamin-rich snack for work. In the end, sunlight may be good for you, but it's not the only way to get your fix of vitamins.

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The Mediterranean diet may be good for the bones


One of the keys to healthy aging is to protect the skeleton. While many people know that vitamin D and calcium are essential to bone health, they may not realize that their weight can also play a role. For example, a 2007 study published in the American Journal of Clinical Nutrition found that being overweight can be damaging to the bones. Furthermore, the increased pressure that being overweight places on the joints may cause pain.

Recently, a new study suggested that there may be a way to promote the health of bones and weight loss at the same time. Research published in the Journal of Clinical Endocrinology and Metabolism shows that following a Mediterranean diet may have protective benefits for bones. Furthermore, this diet has been used as an effective weight loss tool for many years.

Good for bone and cardiovascular health

According to researchers, olive oil, which is a staple of the Mediterranean diet, has been associated with bone health.

"The intake of olive oil has been related to the prevention of [bone problems] in experimental and in vitro models," said José Manuel Fernández-Real, M.D., Ph.D., of Girona, Spain, and lead author of the study.

Researchers found that people who consumed a Mediterranean diet with virgin olive oil were found to have improved bone health over those who consumed a low fat diet or a Mediterranean diet that included mixed nuts, but not as much olive oil. Furthermore, people who ate more olive oil had higher calcium levels than the others.

Other benefits of the Mediterranean diet

Along with potentially helping the bones, the Mediterranean diet has been associated with improved cardiovascular health. According to staff at the Mayo Clinic, this eating plan mostly consists of fruits, vegetables, whole grains, fish and olive oil. Many of the components of this diet, such as salmon, anchovies and olive oil, are all good sources of omega-3 fatty acids.

Some people who follow the regimen have also seen improvements in their cholesterol levels. This is likely due to the fact that while following the Mediterranean eating plan, people are supposed to replace butter with olive oil, which has less saturated fat.

Finally, the Mediterranean diet encourages people to drink moderate amounts of red wine, which contains resveratrol, a powerful antioxidant.

So, people who are interested in potentially improving their bone and heart health should consider trying a Mediterranean diet. 

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How can you get more vitamin D into your diet?


Vitamin D is an important nutrient that supports joint health and overall well-being. Sun exposure is the main source of vitamin D for most people, but not for everyone. There are many individuals who do not get to spend time outdoors each day, and these people sometimes struggle to maintain healthy vitamin D levels. Recently, Health magazine listed alternative ways that individuals can increase their vitamin D intake.

First, the news source stated that fatty fish, such as salmon and trout, contain both vitamin D and omega-3 fatty acids, another essential nutrient. The National Institutes of Health (NIH) recommends that adults up to age 70 get 600 international units (IUs) of vitamin D a day, while those over age 70 need 800 IUs daily. According to the Post, a three-ounce sockeye salmon fillet contains about 450 IUs of vitamin D.

Also, certain mushrooms have been shown to contain vitamin D, as long as they were not grown in the dark.

"Check to see if vitamin D-rich 'shrooms, like Dole's Portobello Mushrooms, are available at a store near you. They're perfect for vegetarians looking for plant-based foods that contain the vitamin. Dole's portobellos will give you 400 IUs of vitamin D per serving (about one cup of diced mushrooms)," according to the news source.

The NIH states that fortified milk, orange juice and cereals are another way people can work more vitamin D into their diet. Furthermore, egg yolk also contains the nutrient, but only about 40 IUs per serving. Finally, people who have serious vitamin D deficiencies should consider taking a supplement to improve their levels. 

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Vitamin D may help boost your mood


People with vitamin D deficiency may experience a number of problems, such as decreased bone health. This is why it's so important for individuals to get enough of this nutrient through sun exposure, food or vitamin D supplements. Recently, research presented at The Endocrine Society's 94th Annual Meeting in Texas suggested that maintaining vitamin D levels is not just important for the body, but the mind as well.

Researchers from the Bayhealth Medical Center in Delaware found that women experienced support for their mood when they received treatment for their vitamin D deficiency.

"Vitamin D may have an as-yet-unproven effect on mood," said researcher Sonal Pathak, M.D., an endocrinologist at Bayhealth.

The women in the study ranged in age from 44 to 66, all of whom were having trouble controlling their moods. These women also had had risk factors for vitamin D deficiency, such as low vitamin D intake and inadequate sun exposure, which is a common problem for older females.

Over the course of eight to 12 weeks, the women took vitamin D supplements to help their levels return to normal. After taking the supplements, study participants reported that they experienced improvements in their mood. This is one of a number of studies that have found that vitamin D may have an impact on mental health.

According to the Vitamin D Council, one study of elderly individuals found that individuals who reported problems with their mood had vitamin D levels 14 percent lower than others.

These findings should encourage people to get more vitamin D. People can consume fatty fish such as tuna or salmon, or fortified milk and cereal to help them increase their levels of this nutrient. There are also many vitamin D supplements on the market. 

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