Many know vitamin D’s link with bone health, and how the deficiency of this sunshine vitamin can increase the risk of fractures, osteoporosis, and rickets. However, a growing body of research shows that its impact transcends physical health and might affect mental health too.
“Vitamin D is considered to be a crucial factor that influences symptoms of depression, negative emotions, and quality of life,” says Dr Jyoti Kapoor, senior psychiatrist, and founder of Manasthali. “In the United States, much evidence has been found where Vitamin D deficiency has played a role in depression and possibly other mental disorders,” she adds.
The association is more pronounced in the case of depression. Recent research has shown that those suffering from depression also have low vitamin D levels in their blood.
Research on vitamin D supplementation has also found a similar link. For instance, in some studies, participants experienced an improvement in depression symptoms when taking vitamin D supplements.
Several studies, in particular, have suggested a link between low vitamin D levels and postpartum depression. It is a type of depression that affects women after giving birth. A similar association has been found between this vitamin and patients suffering from gout, multiple sclerosis, injuries to the spinal cord, and stroke.
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“A deficiency of vitamin D can compromise brain function and increase symptoms of depression, irritability, anxiety, and more,” Dr Kapoor says.
It is to be noted here that although a deficiency of vitamin D has been found in patients suffering from depression, the deficiency has not been found to cause the illness.
What is the connection?
Although research hints at a connection, it is yet to be established and more studies are needed for the same. And despite a direct link between vitamin D supplementation and anxiety/ depression is yet to be established, “its involvement as an additional factor in the causation of psychiatric issues is undeniable,” says Dr Kapoor.
“Low levels of vitamin D are associated with higher levels of depression and anxiety in several studies. It may also be due to low exposure to sunlight as UV rays in sunlight cause the formation of vitamin D in the body and also impact mood positively. Similarly, our gut health is connected to both vitamin D and psychological state,” Dr Kapoor adds.
“Apart from the well-known effect on calcium metabolism, low levels of vitamin D are also associated with cognitive decline. In fact, it is seen that Vitamin D acts more like a hormone in the body thus having varied roles across various organ systems including the brain and nervous system,” the psychiatrist adds.
Sreemathy Venkatraman, chief clinical dietician at Trustwell Hospitals and founder of Mitha Ahara: Eat to live, specifically points to dementia, which causes forgetfulness. “So, not just bone and muscle health, but vitamin D has a lot of impact on mental and brain health too,” she says.
“Vitamin D is crucial not only for bone health but for proper brain development and functioning. Research suggests that vitamin D deficiency may be linked to an increased risk of mental health disorders such as depression and anxiety. A lack of vitamin D may also worsen symptoms in people with pre-existing conditions related to mental health,” explains Dr Prachi Jain, a dietician at CK Birla Hospital, Gurugram. Sunlight remains its primary source.
Given vitamin D’s impact on physical and now mental health, it is crucial to understand how it works. “Vitamin D is a fat-soluble vitamin that helps the body to absorb and retain calcium and phosphorus,” explains Dr Jain.
Our brain, heart, muscles, and immune system have vitamin D receptors. The vitamin is then transported to the kidneys and liver, where it is converted into an active hormone, as per WebMD. Although it has been linked to depression, seasonal affective disorder (SAD), and even schizophrenia, a major impact is seen on bone health, given its link with calcium.
“It’s important to get enough vitamin D as low levels of vitamin D in the body can damage the bones and make them weak,” says Dr Jain.
However, it does not stop here. Its deficiency “can also increase the risk of infections. It also helps with inflammation and immune functions,” she says. “It is not just a vitamin but also acts as a hormone and also helps in metabolism, which is how we burn food,” explains Venkatraman. “In different ways, it also helps in maintaining hormonal balance,” she adds.
Given that sunlight is the primary source of it, those who do not spend enough time outdoors are at a greater risk of vitamin D deficiency. “Such as the elderly, who spend more time indoors due to drop in mobility and risk of fall; students preparing for exams; and everyone who spends more time indoors,” says Venkatraman.
“Also, an increasing number of people nowadays use SPF to prevent their exposure to the sun’s harmful UV rays, but it is crucial to expose oneself to the morning sunshine for at least 20 minutes,” she says. The role of melanin should also be noted here. It is responsible for skin pigmentation. The more melanin your body has, the darker your skin will be. The pigment which “acts as a shield against sunlight can put them at a risk for vitamin D deficiency,” the dietician explains.
“Studies have shown that Indians are at a higher risk of vitamin D deficiency due to factors such as skin pigmentation, cultural practices that limit sun exposure, and inadequate dietary intake. Therefore, supplementation or increased sun exposure is recommended to prevent deficiency and the associated health risks,” Dr Jain says.
“People who are obese and those suffering from medical conditions like malabsorption syndromes, too, are at a greater risk,” she adds.
While sunlight remains a primary source, several foods also serve as good options. For example, “fatty fish, egg yolk, and certain mushrooms,” Venkatraman recommends. Then comes fortified foods. “In India, the +F mark on foods indicates they have been fortified with vitamins D. For example, some brands of milk, edible oil, and cereals have this mark. Vegetarians can opt for these options,” she says.
Doctors also prescribe supplements to those suffering from vitamin D deficiency. These are available in the form of pills, capsules, and liquid drops. “It is important to take vitamin D supplementation in consultation with the doctor as excessive intake can lead to toxicity,” cautions Dr Jain. “A balanced diet including vitamin D-rich foods like fatty fish, egg yolks, and fortified dairy products can also help in addressing the deficiency,” she adds.
Not just vitamin D, but some other vitamins and minerals have also been linked with mental health. “Vitamin B-12 and other B vitamins play a role in producing brain chemicals, which affect mood and other brain functions. Hence, low levels of vitamin B-12 and other B vitamins like B-6 and folate may be associated with depression,” says Dr Kapoor.
Some connection has also been found between vitamin C and depression, based on studies on animals. However, human trials are needed here. A similar link can be drawn between iron and magnesium; however, more research is needed.
Given vitamin D’s deep impact on a person’s overall health, it is better to prevent its deficiency. “To do that, it is important to get adequate sun exposure, consume vitamin D-rich foods, and consider supplements, if necessary,” recommends Dr Jain.
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MENTAL HEALTH EMERGENCY
* In 2019, 1 in every 8 people, or 970 million people around the world were living with a mental disorder, with anxiety and depressive disorders the most common
* In 2020, the number of people living with anxiety and depressive disorders rose significantly because of the Covid-19 pandemic— by as much as 26% and 28%, respectively
* In 2019, 40 million people experienced bipolar disorder
* Schizophrenia affects approximately 24 million people or 1 in 300 people worldwide. People with schizophrenia have a life expectancy 10-20 years below that of the general population
* In 2019, 40 million people, including children and adolescents, were living with conduct-dissocial disorder, also known as conduct disorder—a disruptive behaviour and dissocial disorder
* In 2019, 280 million people were living with depression, including 23 million children and adolescents
* In 2019, 14 million people experienced eating disorders including almost 3 million children and adolescents
(Source: World Health Organization)