February 8, 2023

This is a short video about Vitamin D for the treatment of depression.

Hi my name is dan and i’m a mental health pharmacist and today i wanted to do a video about vitamin d for the treatment of depression where i’m located it is currently winter and people get less sunlight during this time so i thought that it was a good time to make a video about vitamin d additionally this video will talk about some of the differences between vitamin

D2 versus vitamin d3 first i wanted to start with some background vitamin d is an essential or some sources consider it a non-essential fat-soluble vitamin first it’s important to know the differences between an essential and a non-essential vitamin and then a fat soluble versus a soluble vitamin and a central vitamin must be obtained from the diet where as a

Non-essential vitamin can be synthesized in the body some sources consider vitamin d a non-essential vitamin because your body can synthesize it when exposed to sunlight while other sources consider vitamin d an essential vitamin because many people still need to obtain vitamin d through supplementation for example people who live in climates that don’t get much

Sunlight may need to ex may need to receive their vitamin d through supplementation additionally melanin absorbs the ultraviolet radiation that’s needed to initiate vitamin d synthesis so people with dark darker skin tones may not produce as much vitamin d from sunlight from sunlight or sun exposure and may also need to obtain vitamin d through supplementation

Vitamin d is fat soluble which means that it’s dissolvable in fat and is stored in the liver and fatty tissues for future use this differs compared to water soluble vitamins which are dissolvable in water and they’re either used immediately or excreted in the urine if too much of a water soluble vitamin is taken it’s generally not that big of a deal because

You excrete the excess whereas fat soluble vitamins too much can be taken of them because they’re stored in the body for future use so too much of a fat soluble vitamin can cause dangerous effects examples of fat soluble vitamins include vitamin a vitamin d vitamin e and vitamin k finally there are a few types of vitamin d such as ergocalciferol vitamin d2

Which is historically obtained from plant sources and cholecalciferol vitamin d3 which is traditionally obtained from fish and lanolin a product from sheep’s wool but now can be obtained from plant or fungi based sources as well both types are metabolized to calcitriol which is the active form foods that contain vitamin d include oily fish red meat liver eggs and

Fortified foods many people get their vitamin d through supplementation how does vitamin d help with depression depression is associated with inflammation in the brain and low vitamin d levels are associated with higher levels of inflammatory markers therefore vitamin d may be beneficial in depression by decreasing neural inflammation additionally i found a study

In children with adhd who were given vitamin d 3 supplementation and this study showed that this increased dopamine levels dopamine increasing dopamine can be helpful in depression as well the exact mechanism of how vitamin d helps with depression is not known but these are some of the theories and some of the evidence that exists now i want to go into the dosing

Of vitamin d in the united states vitamin d is listed in micrograms mcg while in other countries the dosing may be listed in international units iu to convert from iu to micrograms you simply divide the iu by 40. or if you’re converting the other way you multiply it by 40. so for example the recommended daily allowances depend on age so for someone age one through

70 the recommended amount of vitamin d is 600 international units or 15 micrograms and if someone is age 71 or older the recommended daily allowance is 800 international units or 20 micrograms the current recommended daily dietary allowances assume that vitamin d2 and vitamin d3 are equally absorbed and this is not believed to be the case multiple studies show

That cholecalciferol vitamin d3 is absorbed three times as readily as ergocalciferol vitamin d2 one of the issues with this is that ergocalciferol is obtained from typically plant sources where historically chola calciferol has been obtained from animal sources such as oily fish or such as lanolin which is made from wool of woolly animals currently there are some

Options for vitamin d3 that are plant and fungi based so this product here is one that i purchased and it’s vitamin d3 from lichen which a quick google search says is a symbiotic symbiotic relationship between fungi and algae so typically not all plant-based are technically not all plant-based because fungi are not plants but i believe that this product would

Be both vegetarian and vegan friendly but if someone can educate me more about lichen and if they’re appropriate for vegans and vegetarians that would be appreciated finally in regards to dosing taking vitamin d with a high fat meal can increa can increase absorption by 20 percent because like i said before vitamin d is a fat soluble vitamin and easily dissolved

In fats now i wanted to talk about some of the evidence in using vitamin d for the treatment of depression the first question i wanted to answer is can vitamin d deficiency cause depression i found a meta-analysis of over 32 000 patients that showed that the group with the lowest vitamin d level were more than twice as likely to develop depression as compared to

The group with the highest vitamin d level so this shows that vitamin d deficiency may indeed be linked with depression next does vitamin d treat depression i found a meta-analysis of 948 patients that was a combination of four different trials in this showed that vitamin d had a moderate effect size in the treatment of depression the studies varied in length

From on the shorter end at eight weeks to the longer end at 52 weeks three of the trials were of oral vitamin d with doses between 1500 international units and 50 000 international units weekly rather than daily and one trial included intramuscular vitamin d all of note all of the trials used vitamin d3 the cholecalciferol that’s more readily absorbed as compared

To the ergocalciferol but again this the conclusion of this study showed a moderate effect size in the treatment of depression the next meta-analysis that i wanted to look at found efficacy in studies that measured vitamin d before and after supplementation to actually show that we were increasing the serum levels of vitamin d the study concluded that vitamin

D supplementation greater than or equal to 800 international units daily had an effect size that was comparable to that of prescription antidepressant medications the final question that i wanted to answer is does vitamin d prevent depression so a trial looked at this and it followed over 18 000 adults over a five-year period people in the treatment group

Took vitamin d3 2000 international units per day and fish oil and the other group took a placebo treatment with vitamin d3 and fish oil did not show a statistically significant difference in the prevention of depression and the authors concluded that they do not support vitamin d3 and is in adults to prevent depression finally i wanted to go over some safety

Concerns with vitamin d natural medicine’s database deems vitamin d to be likely safe when used orally or intramuscularly at appropriate doses oral long-term doses should not exceed 4 000 international units which is 100 micrograms per day for adults but much higher doses can be used for short periods of time to treat vitamin d deficiency as for side effects

Generally vitamin d is well tolerated side effects are rare but possible especially when too much is taken because remember vitamin d is a fat soluble vitamin vitamin d intoxication can cause hypertension which means high blood pressure dry mouth decreased libido osteoporosis eye problems like calcific conjunctivitis and photophobia psychosis and hypercalcemia

Finally vitamin d does have some drug interactions so it’s important to check into this before you start vitamin d supplementation vitamin d interacts with saying things such as atorvastatin brand name lipitor for choleste high cholesterol vitamin d may reduce the absorption of the torvostatin vitamin d may also induce a type of enzyme in your liver called sip3a4

Enzymes so that can have drug interaction effects as well vitamin d affects digoxin potentially vitamin d affects calcium because vitamin d increases the absorption of calcium so taking too much calcium and too much vitamin d can lead to high amounts of calcium in the body finally certain drugs may reduce blood levels of vitamin d so may require someone to take

More vitamin d or take vitamin d supplementation example drugs include carbamazepine corticosteroids phenobarbital phenytoin and more drugs than that so in conclusion there are some studies that support vitamin d for the treatment of depression of note almost all the studies that i found were using vitamin d3 which is cola calciferol and more readily absorbed than

Ergocalciferol i hope this video was helpful and thank you for watching

Transcribed from video
Vitamin D2 or D3 for depression? By Dan Greer