COVID D-PRIVED AND DOWN? HOW VITAMIN D DEFICIENCY CAN CONTRIBUTE TO LOW MOOD

(Editor’s Note: This includes information for people with Parkinson’s)

If you're feeling down in the dumps, a vitamin D deficiency — potentially due to social distancing — may be contributing. So, you're several months into social distancing, and you're feeling blue.

            “We’re seeing a lot of anxiety around COVID-19, and also feelings of being trapped, not being able to connect or engage in pleasurable activities, or not having the typical outlets that help with mood,” says Kristen C. Wynns, PhD, psychologist and founder of Wynns Family Psychology in Cary and Raleigh, North Carolina. “People are struggling, and even the highest functioning person is impacted,” she says.

            There are many reasons why you might feel down these days — but could a vitamin D deficiency be contributing?

            “I think a number of people are experiencing depression or low mood due to social isolation and a vitamin D deficiency — I believe it’s a combination of both factors,” says Sue Penckofer, PhD, RN, graduate school associate dean at the Loyola University Chicago, who has coauthored numerous studies on vitamin D and mood.

            How Social Distancing During the COVID-19 Pandemic May Be Contributing to Low Vitamin D Most people get the vitamin D they need thanks to the sunlight. “We know that when sun hits the skin, there’s a synthesis that causes your body to produce the vitamin,” says Dr. Penckofer. Also, some foods, like eggs and salmon, contain vitamin D, according to the Cleveland Clinic, but a supplement can help increase your levels further.

            But with so many of us stuck inside because of social distancing, we likely aren’t getting the typical sun exposure we otherwise would this time of year. And that, potentially, could mean low levels of vitamin D — and a low mood, says Penckofer.

            In fact, joint guidelines from the American Society for Bone and Mineral Research, the Endocrine Society, the American Association of Clinical Endocrinologists, the European Calcified Tissue Society, the National Osteoporosis Foundation, and the International Osteoporosis Foundation recommend considering vitamin D supplementation during the pandemic. This is because more people are spending time indoors, potentially increasing the risk of deficiency. "For those unable to spend at least 15 to 30 minutes with direct sun exposure each day," they wrote in their July 9, 2020, statement, "the easiest way to acquire vitamin D is through food supplemented with vitamin D or vitamin D nutritional supplements."

            Read on to discover how your potentially low levels of vitamin D might be bringing you down — and what you can do about it.

            The Connection Between Low Vitamin D and Low Mood, According to Science. Researchers have been studying the link between vitamin D and mood for decades, though questions remain. “People who have low vitamin D are more likely to feel less positive — at this point we may not fully understand the connection and mechanisms, but the evidence of an association is certainly there,” says Maria Choukri, PhD, a senior lecturer at Ara Institute of Canterbury in New Zealand, who researches vitamin D.

            Here’s what experts do know: “Both low vitamin D and depression have been connected to inflammation, so it is likely that the underlying reason has to do with inflammation,” says Dr. Chourki.

            Vitamin D also affects the serotonin pathway, Penckofer says. This hormone does everything from regulate mood to sleep, and appetite to motor skills, just to name a handful of functions, according to Stanford University. “Vitamin D is important for helping the enzyme that makes serotonin — when levels are low, you aren’t making as much serotonin,” adds James Greenblatt, MD, chief medical officer at Walden Behavioral Care in Waltham, Massachusetts, and assistant clinical professor of psychiatry at Tufts University School of Medicine in Boston. 

            Supplementing With Vitamin D May Improve Mood, Studies Suggest Penckofer coauthored a paper published in September 2017 in the Journal of Diabetes Research that found vitamin D supplementation improved the mood of women with type 2 diabetes, which is a group that is at an elevated risk for depression, the Mayo Clinic notes. They are also among the groups at a higher risk for vitamin D deficiency, noted a past review that Penckofer coauthored.

            Whether it’s due to depression, body image struggles, or inactivity, “people who have diabetes are more likely to stay indoors, so they aren’t getting the sunlight, the outdoor exercise, and the opportunities to socialize,” which are other factors that can affect mood, says Penckofer. Due to the potential dangers of COVID-19 to their health, people with type 2 diabetes, along with others who have underlying health conditions, may be going out even less than usual — and this could further reduce their vitamin D levels and quality of mental health. 

            Though the women in Penckofer’s 2017 study took 50,000 IU (international units) of vitamin D — which is considered a very high amount — for six months, her more recent research found that even taking a lower dose of vitamin D is effective in raising vitamin D levels and improving mood for women with type 2 diabetes and depression.

            More Studies on Vitamin D and Mood Are Needed. Still, not every study shows vitamin D is a mood cure-all. One of Choukri’s studies, published in August 2018 in the Journal of Nutritional Science, found that supplementation in healthy women did not provide any benefits to psychological well-being — but taking a break did. “Most of our participants were staff or students at a university, and there was an improvement in well-being for both the vitamin D and placebo groups during the university holiday period!” explains Chourkri.

            How Vitamin D Status, Diet and Lifestyle Habits, and Mood Are Interconnected. Mood, diet and lifestyle habits, and vitamin D status are all closely connected. Low vitamin D may trigger low mood, making it more difficult to sleep, eat well, and exercise regularly, says Choukri. Yet, she adds, “These difficulties may be due to the mood itself rather than vitamin D.”

            On the flip side, research suggests that not getting enough sleep, having a poor-quality diet, and inactivity can contribute to low mood independently, regardless of vitamin D status.

            Here’s a closer look at the relationship among vitamin D status, these habits, and mood and health.

            Vitamin D and Sleep. There’s a scientific link between getting adequate vitamin D and sleeping well, which plays a role in mood on its own. “Vitamin D is important in the process of making serotonin, and you need serotonin to make melatonin,” says Dr. Greenblatt. Melatonin is a hormone that promotes sleep, according to the Mayo Clinic.

            A meta-analysis published in October 2018 in the journal Nutrients concluded that vitamin D deficiency is linked with a higher risk of sleep disorders.

            It’s all connected: Lack of sleep alone, regardless of vitamin D status, may contribute to depressive symptoms, along with anxiety, notes the National Sleep Foundation. According to the Mayo Clinic, symptoms of depression may include tiredness and a lack of energy, sleep disturbances like insomnia, and a loss of interest in pleasurable activities.

            Vitamin D and Exercise. Low mood from vitamin D may make someone less likely to be active, says Penckofer. And inactivity can trigger a vicious cycle that further contributes to low mood. A study published in April 2019 in the International Journal of Environmental Research and Public Health found that sedentary behavior and low physical activity were linked to anxiety and depression. And a review published in June 2015 in Cognitive Behavior Therapy found that exercise can even help reduce anxiety symptoms and bad mood, the authors noted. Another study, published in September 2018 in The Lancet Psychiatry, found that all types of exercise — from walking to cycling — were associated with improved mental health.

            According to the Mayo Clinic, exercise boosts endorphins, gets your mind off stressful situations, gives you confidence, and can provide social interaction.